[Patient view in the assessment of quality of life in old age: potentials and limits].

Quality of life is a multidimensional construct commonly used in geriatric health care. The patient's view is increasingly incorporated in its determination. Pain and satisfaction with life are two important subjective facets of quality of life. Potentials and limits of an integration of the subjective view in seemingly heavily disadvantaged patient populations are discussed using three approaches: 1) Self-reports on pain in aphasic patients can often be obtained by means of nonverbal communication or verbal communication adapted to the disorder. 2) Even in people suffering from dementia, pain can be assessed in self-reports into the middle stages of the disease. In severe dementia, observational methods have been developed, but their significance with respect to the experience of pain is still being debated in the scientific community. 3) Differences in content and structure in the individual construction of life-satisfaction in multimorbid elderly without cognitive impairment can be reproduced by an individualized measurement tool (FLQM). It allows for determination as well of global and domain-specific life-satisfaction as of differential determinants of longitudinal changes. All three approaches highlighted potentials for an extended integration of the patient's perspective in the assessment and evaluation of their quality of life.