Or a rescue swimmer in the water. There was a recent MOB in a CA coastal race where the elderly MOB went over w/o flotation and a crew member dove in, kept the OG MOB's head above water. I don't know if this was prior to them dropping the kite and turning around, or if it was part of getting a line attached to the the MOB back on board.
Some big boats, like Comanche, have a dedicated swimmer of the watch who's trained and ready to go for a swim to help get a MOB back on the boat. Not sure that's the best idea for most of us, but might eliminate the risk of killing the MOB with the bow in