Objective: To evaluate the impact of mindfulness intervention combined with affectionate nursing on the physical, emotional, and quality-of-life outcomes of elderly patients with uremia undergoing maintenance hemodialysis, with a focus on promoting holistic well-being and its implications for physical activity and sports engagement. Methods: A retrospective study was conducted on 120 elderly uremic patients admitted to our institution between January 2020 and October 2022. Based on different care protocols, patients were divided into a control group (60 cases, routine nursing) and an experimental group (60 cases, mindfulness intervention combined with affectionate nursing). Parameters such as compliance, satisfaction with nursing care, psychological well-being, hope levels, coping strategies, quality of life, and self-management abilities were assessed and compared. Results: Nursing satisfaction was significantly higher in the experimental group (95.00%) compared to the control group (81.67%, P < 0.05). Psychological distress markers, including SAS and SDS scores, were significantly lower in the experimental group (P < 0.05). Compliance and self-management scores were markedly higher in the experimental group (P < 0.05). Improvements in hope levels and quality of life were significantly greater in the experimental group, with a particular focus on dimensions influencing physical activity and motivation for rehabilitation. Additionally, the experimental group exhibited better adaptive coping strategies, including higher "facing" scores and lower scores for "yield" and "avoidance" dimensions (P < 0.05). Conclusion: Mindfulness intervention combined with affectionate nursing significantly enhances the quality of life, psychological resilience, and self-management abilities of elderly patients undergoing hemodialysis. These improvements foster greater participation in physical activity and rehabilitation programs, highlighting the potential for integrating such interventions within sports and health sciences frameworks. The findings underscore the importance of holistic care approaches in promoting physical and emotional well-being in elderly populations, warranting further application and research in multidisciplinary health settings.