Comment by DanBC | Hacker News Reader

Comment by DanBC | Hacker News Reader

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Yes. For illnesses like diabetes it's best if you can prevent people getting it, but if they have it it's best if you can help them to avoid getting the complications.

"Diabetic foot" sounds funny, until you realise that it kills people and is a reason for leg amputation. (Prognosis after such amputation wasn't great last time I looked, in about 2004.)

Sending a real person in a car to visit someone at their home sounds intensive, and sounds expensive. Compare it to a tele-medicine device that takes measurements and sends those to a centre somewhere, with people calling over the phone. It's a shame that the evidence base appears to be being ignored. EDIT (after adestefan and ajtaylor commented) -- it feels expensive, but the evidence base is clear that it's not expensive because it works, where as the thing that feels cheap is wasted money because evidence shows it doesn't work. And it's a shame that people in charge appear to be ignoring evidence, and going by 'gut feeling', because it means effective interventions are not happening.

I hope that mentioning the research that a decision is based on becomes more widespread. Even organisations that claim to be evidence based can make odd decisions.

I would agree with you as long as the devices you're referring to are completely automated and rely 0% on the person to do something. My grandmother didn't remember things so well as she got older, so without someone to help her to remember to take her medicine (or that she had indeed taken it) it would have had real implications for her health. As it happened, she had my mother and later my uncle to take the place of the nurse. In my limited experience, the key to seniors is to avoid having to rely on their memory.

As for avoiding complications, I agree with you. The best action is to avoid the disease, and then to avoid the effects of the disease.

As mentioned in the article, sending a person in a car to visit someone is obviously more expensive than a phone call. But the nurse's visit can help to avoid a problem which requires a far more expensive visit to the hospital. That is where the cost savings come into play.

There is something special about having that physical person with you, in your home, talking to you one on one. Yes it's somewhat expensive up front, but the human contact is a major component of what makes this a success.

There is one extra photo in the print edition of this story. It's the nurse, Ms. Graefe, hugging Mr. Bradfield in his kitchen.

Because much of our health needs are mental, and much of mental health is social. Living alone is a chronic debilating condition, akin to diabetes.

Live with your parents, and later live with your kids. Or outsource to home aides.

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