Abstract: This study explores the mechanism through which intergenerational support-related factors influence the health literacy of the elderly in the context of surrogate health information seeking, and provides a theoretical reference for cultivating health literacy among the elderly. A configuration analysis framework is formed based on sense-making theory. Then, the fuzzy-set Qualitative Comparative Analysis(fsQCA) method is employed to analyze the configuration path of 331 questionnaires completed by elderly participants. The findings indicate that no single factor necessarily impacts the health literacy of the elderly. Intergenerational support contributes to overall health literacy, as well as functional, interactive, critical, and translational health literacy, with 3, 5, 1, 1, and 7 configuration pathways identified respectively. The empowerment of health literacy of the elderly by intergenerational support is the result of multiple factors. Cultivating health literacy among the elderly requires that children provide both instrumental and emotional support, while also emphasizing the subjective initiative of the elderly in sense making.