In the December issue Iliffe1 assured us that our article ‘anticipatory care of older patients represented the triumph of hope over experience’.2 We find this a bewildering claim in view of the extensive research evidence to the contrary. No less than six controlled trials between 1979 and 1993 showed that a programme of care, tailored to the special needs of those in advanced old age, reduced the time spent in institutional care (hospitals and nursing homes). They are referenced in our book.3 In addition Beswick in 2008, a much more recent meta-analysis than that cited by Iliffe,4 has made a thorough appraisal of nearly all the research work done in this field. From 89 studies he showed that interventions reduced the risk of not living at home, of nursing-home and hospital admissions and falls. However death rates were not reduced.
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