quality of life (healthcare) quality of life (healthcare) in general, quality of life (qol or qol) is the perceived quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. this includes all emotional, social and physical aspects of the individual's life. in health care, health-related quality of life (hrqol) is an assessment of how the individual's well-being may be affected over time by a disease, disability or disorder. the economist intelligence unit's quality-of-life index, 2005 8.000 - 8.999 7.000 - 7.999 6.000 - 6.999 5.000 - 5.999 4.000 - 4.999 3.000 - 3.999 no data measurement early versions of healthcare-related quality of life measures referred to simple assessments of physical abilities by an external rater (for example, the patient is able to get up, eat and drink, and take care of personal hygiene without any help from others) or even to a single measurement (for example, the angle to which a limb could be flexed). the current concept of health-related quality of life acknowledges that subjects put their actual situation in relation to their personal expectation. the latter can vary over time, and react to external influences such as length and severity of illness, family support, etc. as with any situation involving multiple perspectives, patients' and physicians' rating of the same objective situation have been found to differ significantly. consequently, health-related quality of life is now usually assessed using patient questionnaires. these are often multidimensional and cover physical, social, emotional, cognitive, work- or role-related, and possibly spiritual aspects as well as a wide variety of disease related symptoms, therapy induced side effects, and even the financial impact of medical conditions. although often used interchangeably with the measurement of health status, both health-related quality of life and health status measure different concepts. activities of daily living main article: activities of daily living activities of daily living (adls) are activities that are oriented toward taking care of one’s own body and are completed daily. these include bathing/showering, toileting and toilet hygiene, dressing, eating, functional mobility, personal hygiene and grooming, and sexual activity. many studies demonstrate the connection between adls and health-related quality of life (hrqol). mostly, findings show that difficulties in performing adls are directly or indirectly associated with decreased hrqol. furthermore, some studies found a graded relationship between adl difficulties/disabilities and hrqol- the less independent people are at adls- the lower their hrqol is. while adls are an excellent tool to objectively measure quality of life, it is important to remember that quality of life goes beyond these activities. for more information about the complex concept of quality of life, see information regarding the disability paradox. in addition to adls, instrumental activities of daily living (iadls) can be used as a relatively objective measure of health-related quality of life. iadls, as defined by the american occupational therapy association (aota), are “activities to support daily life within the home and community that often require more complex interactions than those used in adls”. iadls include tasks such as: care for others, communication management, community mobility, financial management, health management, and home management. activities of iadls includes: grocery shopping, preparing food, housekeeping, using the phone, laundry, managing transportation/finances. research has found that an individual’s ability to engage in iadls can directly impact their quality of life. pharmacology for older adults elderly patients taking more than five medications increases risk of cognitive impairment, and is one consideration when assessing what factors impact qol, adls, and iadls of older adults. due to multiple chronic conditions, managing medications in this group of people is particular challenging and complex. recent studies showed that polypharmacy is associated with adl disability due to malnutrition, and is a risk factor for hospital admission due to falls, which can have severe consequences on a person's quality of life moving forward. thus, when assessing an elderly person's quality of life, it is important to consider the medications an older patient is taking, and whether they are adhering to their current prescription taking schedule. occupational therapy’s role occupational therapists (ots) are global healthcare professionals who treat individuals to achieve their highest level of quality of life and independence through participation in everyday activities. ots are trained to complete a person-centered evaluation of an individual’s interests and needs, and tailor their treatment to specifically address adls and iadls that their patient values. in the aotas most recent vision statement (2025) they explicitly state that ot as an inclusive profession works to maximize quality of life through the effective solution of participation in everyday living. to learn more about occupational therapy, see the wikipedia page dedicated to the profession. special considerations in palliative care hrqol in patients with serious, progressive, life-threatening illness should be given special considerations in both the measurement and analysis of hrqol. oftentimes, as level of functioning deteriorates, more emphasis is put on caregiver and proxy questionnaires or abbreviated questionnaires. additionally, as diseases progress, patients and families often shift their priorities throughout the disease course. this can affect the measurement of hrqol as, oftentimes, patients change the way they respond to questionnaires which results in hrqol staying the same of even improving as their physical condition worsens. to address this issue, researchers have developed new instruments for measuring end-of-life hrqol that incorporate factors such as sense of completion, relations with the healthcare system, preparation, symptom severity, and affective social support. additionally, research is being conducted on the impact of existential qol on palliative care patients as terminal illness awareness and symptom burden may be associated with lower existential qol. examples