TOLERATED ILLNESS concept and theory for chronically ill and elderly patients as exemplified in American Indians.

Background: The TOLERATED ILLNESS phenomenon refers to a noted discordance between subjective and objective health measures in the chronically ill patient. The TOLERATED ILLNESS theory of care helps explain why some patients will report good to excellent health in spite of their having low functional ability.

Methods: TI facilitates provider recognition of this largely unrecognized phenomenon and is instructive as to the why's for the patient tolerating illness.

Results: The goal of presenting this theory is to provide a way to identify, assess, and assist those previously silent with unmet needs to bring about optimum patient outcomes.

Conclusions: Importantly, patient and provider goals may diverge.