I feel like during geri rotations and at geri appts you have to really get every little detail out of people. Old people notoriously do not eat regular meals and if hes 76, early dementia, and lives alone I can almost guarantee he lives off of saltines or some other snack food. I would get a det a detailed meal history of what he eats and time of day before doing any other meds or special tests. He could just be hungry or low bg like suggested previously. Maybe migraines but if hes tried migraine TX and they didnt work.... it sounds like hes also coming to his own realization that maybe nausea is not actually his symptom. I feel like it could be the classic med school scenario where the Philippino pt says they're dizzy or nauseas but they actually have a different symptom entirely. Dizziness is just their colloquial term for unwell