6.3.4 Providing end-of-life care for people with TB

End-of-life care can be provided either in an inpatient setting (hospital or hospice) or in the home depending on: the preference of the patient; the willingness of the relatives and community to provide home care; the presence of a medical need for inpatient care; and the existing capacity for proper infection control in each setting (91, 122). Palliative home care combined with strict infection control may be preferred by many patients and may be less expensive than institutional care for health-care systems. Patients could be with family and friends rather than isolated in an institution that may be far from home. Those who are well enough may be able to engage with family in income-earning activities such as crafts or Internet-based businesses. However, adherence to infection control measures should be a prerequisite for remaining at home. TB programmes should explore opportunities to collaborate with local palliative care programmes to provide palliative home care for people with TB. In addition, TB programmes should build basic capacity for the estimated number of patients in need of institutionally-based end-of-life care either for medical reasons or because of the lack of relatives or community members willing to provide home care.

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