Just this month, Trump has called the Democratic vice-presidential nominee a “monster,” retweeted images of a man being shot, suggested Gold Star families may have infected him with covid-19, amplified a conspiracy theory questioning Osama bin Laden’s death, openly denigrated his own attorney general, attacked the nation’s leading infectious-disease expert, pulled out of a presidential debate, announced a complete withdrawal of troops from Afghanistan, called off talks for a stimulus package and restarted the talks calling for more spending than his party had embraced.

On Tuesday, Trump tweeted a doctored image of Biden in a nursing home with other elderly residents. The tweet — and the Trump campaign’s move earlier in the day to have a former White House doctor declare Biden mentally unfit — came as polls show the president trailing among senior citizens, a group he carried in 2016. One senior administration official said there have been a series of meetings with campaign officials, White House officials and Trump outside advisers on how to fix the president’s problem with senior citizens, but the president keeps making that job harder with his comments and tweets.

Kellyanne Conway, the president’s longtime political adviser, has argued to other aides that the messaging on Biden’s age needs to change, officials said. She spoke with Trump about ideas for his messaging on Wednesday, advisers said.