geriatrics
Quality of Life in Older People
Assessment of Quality of Life
Assessing patients’ perspectives on quality of life may be difficult for the following reasons: Such an assessment is not always taught or emphasized sufficiently in traditional medical education, which tends to be focused on diagnosis and prolongation of life. Quality of life is a subjective, individual experience, so decision models cannot be applied to individual patients. Assessing the patient’s perspectives on quality of life takes time because it requires thoughtful conversation between patient and health care practitioner, and there often is not enough time allotted for these in-depth conversations during traditional fee-for-service–based health care delivery models. People can assess their own quality of life or more specifically their own health. Also known as self-assessed health or self-perceived health, self-rated health (SRH) refers to a single-item health measure in which people rate the current status of their health on a scale ranging from excellent to poor. SRH has been proved a reliable predictor of mortality and disability by a series of national and international analyses ( Assessment reference ). During assessment, practitioners should be careful not to reveal their own biases. Determining a patient's preferences is usually possible; even patients with dementia or cognitive impairment can make their preferences known when practitioners use simple explanations and questions. Having family members present when discussing preferences of a patient with cognitive impairment is recommended. 1.Wu S, Wang R, Zhao Y, et al: The relationship between self-rated health and objective health status: A population-based study.BMC Public Health13:320, 2013. doi: 10.1186/1471-2458-13-320 