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what could be the problem with an 89 year old male with increased confusion combative and poor appetite?

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Poor appetite? His appetite can change with aging as they don't have same sensories. Try offering smaller portions and more frequent that is 5 small meals/day vs 3. Offer snacks, cheese stick, peanut butter cracker, fig newtons or whatever he really likes. Try mixing some protein powder in ice cream or mashed potato to provide the nutrition he needs. Ensure or other protein drinks can be good to sip during the day as well.

My mom doesn't have much appetite when she eats alone and doesn't eat regular meals. We try to go out or change venue by eating a sandwich outside or have a little glass of wine and cheese cubes, crackers and fruit outside in the afternoon to make it seem like a special treat. This perks up her appetite. Sometimes we fix a small picnic and just walk to backyard and eat in a lawn chair. The fresh air and change of scenery seems more special. She loves Arby's, so I bring carry out from there. She's 90 so at this point I don't worry too much about the fast food, she,s down to 90 lbs.

Hope these suggestions help.
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Sounds like my husband of 82 a few weeks back, it was a UTI. Get him tested ASAP & on meds for it, it is nightmare for a caretaker to go through
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Could be a number of things from a UTI, to dementia, to senility, etc.

Make an appt to see a physician that specializes in geriatrics or sees mostly geriatric patients request a full work up when you make the appt. they should do general health screening plus a mental health evaluation appropriate for his age -- be sure to mention recent symptoms and behavior. If you can, document your observations of the behavior, etc and send to dr ahead of time so he can review prior to seeing your elder.

Be patient, he might additionally advise a neurological evaluation before they give a diagnosis.
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