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I think he thought he was doing what was best for his party and country at all times. In my (limited) experience with older people whose cognitive abilities are deteriorating, they are always the last to accept or recognise that it's happening, truly think Joe thought he was fine through all of this.
Maybe, but seemingly not. And if he couldn't recognise that, then you can only conclude he's not medically fit for that office. I'm not an expert, but I do know that you don't deteriorate overnight - he and others will have known, probably for a while, that he wasn't as sharp as he needed to be and the possible direction of travel. Quite apart from the diminished energy that also comes with age - he'd have been 86 at the end of a 2nd term.
Additionally he's been surrounded by highly paid advisers and family who would all have been acutely aware of what the real situation was. And, you'd like to think, would have been frank in telling him so.
So whether you blame Biden personally and / or those around him this situation was totally avoidable and shouldn't have arisen.
There's a reason most people retire or reduce their responsibilities in their 60s.
On a personal level, Biden seems decent and I'm sure will get whatever support he needs. But he shouldn't have been in the conversation for POTUS this time round.