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My Mum is a twin and at 86 they are each hyper aware of each other's health conditions. But they talk on the phone 2-4 times a month, email back and forth and plan annual trips. Currently my Aunt is staying with Mum post knee replacement surgery. It is obvious to Mum and I that Aunt is slipping cognitively. Mum has short term memory issues, but is aware of it and uses a calendar and note pad to keep track of things and remembers to check them daily.
My Aunt is misremembering things from the past, cannot understand that Mum must so her cold water therapy 2x a day, is complaining when Mum asks for help. Aunt said on three occasions she would go buy the ice, but she has not done it once. The ice machine needs 3/4 a bag for each session. She has not once set up the machine for Mum to use. She is physically capable of setting it up, but she will not.
I cannot imagine a situation in which one would not be frank with a brother or any other family member about the diagnosis of their loved one.
What do you mean by "Failure to thrive". That is a symptom, not a diagnosis.
There is always a "reason", whether mental or physical illness, addictions, or something else.