Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- Who leads care
- A psychiatrist experienced in working with older adults; a neurologist in person when indicated
- Format
- Video consultation with the patient and relatives
- Duration
- First appointment about 60 minutes, follow-up every 1–3 months
- Anonymity
- Medical confidentiality under the Kazakhstan Code “On Public Health”
- When it's urgent
- Sudden confusion, hallucinations, falls, thoughts of death — 103 or 112
- Outcome
- An understanding of what is causing the changes and a plan for treatment and care
What you should know
Why has an older person started forgetting recent events, mixing up dates or feeling sad all the time? Not every change in memory is dementia: depression, thyroid problems, vitamin B12 deficiency, medication side effects and sleep disorders can produce a similar picture. Clinical guidelines require these reversible causes to be ruled out before a diagnosis is made. A geriatric psychiatrist looks at the person as a whole: health, medications, daily life and family.
An online consultation is convenient for families in which an older person finds it hard to leave home, especially during the long winter with icy sidewalks and strong winds. Relatives can join from different parts of the city — one from Yesil district, another from the Right Bank — and discuss the situation together. A doctor at Psychiatry Online conducts an interview and memory screening, reviews the list of medications and advises which in-person tests are needed. Follow-up after that can be done online.
Signs worth discussing with a doctor
- forgets recent events, asks the same questions over and over
- gets confused about time, gets lost in long-familiar places
- struggles with everyday tasks: money, medications, cooking
- persistent low mood, tearfulness, talk of having become a burden
- insomnia, wandering around the apartment at night, mixing up day and night
- suspiciousness, accusations of theft, seeing things that are not there
- an abrupt change in personality: irritability, apathy, withdrawal from others
If at least two points apply and the state lasts longer than two weeks, it is worth seeing a specialist. Phone consultation is free. If life is at risk, call 112 or 103.
What causes mental health problems in older adults
The most common causes of cognitive decline are Alzheimer's disease, vascular disorders and dementia with Lewy bodies. In these conditions, nerve cells and the connections between them are gradually damaged. But reversible causes are no less important: depression, hypothyroidism, vitamin deficiencies, metabolic disorders, sleep apnea and medication side effects. That is why a proper evaluation matters, rather than a hasty conclusion that it is “just old age.”
Depression in older adults often shows up not as sadness but as health complaints, fatigue and memory decline. It is triggered by loneliness, bereavement, chronic illness and limited mobility. In winter, when ice and wind keep older people indoors for weeks and daylight hours are short, the risk increases. Sudden confusion may be a sign of delirium, which is a medical emergency.
How an online appointment with a geriatric psychiatrist works
Help the older person sit comfortably, set the camera at face level and check the sound: if their hearing is reduced, it is better to use the speakerphone or headphones. Prepare a complete list of medications, including over-the-counter ones, and recent test results. The doctor talks with the patient, carries out brief memory and attention tests, and then questions the relatives separately. The result is an explanation, a test plan and recommendations on care.
A neurological examination, MRI or CT scans and blood tests are not done online — they are carried out in person. Sudden confusion, hallucinations, high fever, falls or signs of a stroke are a reason to call 103 or 112 immediately. In severe dementia with aggression, a psychiatrist's home visit or hospital care may be needed. Medication is prescribed in accordance with Kazakhstan's legislation.
How we help
Comprehensive assessment
The doctor screens cognitive function and assesses mood, sleep and daily activity. They review all current medications: older adults often experience polypharmacy, when a combination of drugs causes confusion or drowsiness. Tests are ordered to rule out reversible causes — blood tests and brain imaging.
Treating depression and anxiety
Depression in older adults responds well to treatment. Age-adapted psychotherapy and medication from the relevant classes are used, taking co-existing illnesses and drug interactions into account. Prescribing is done cautiously, in accordance with Kazakhstan's rules, with regular monitoring. Online sessions make it possible to track the effect without travel.
Help with dementia
When dementia is confirmed, the doctor discusses medications that can slow functional decline or reduce behavioral symptoms, as well as non-drug approaches: a daily routine, cognitive stimulation and physical activity. An important part is safety at home: locks, gas, medications and fall prevention.
Family support
Caring for a loved one with dementia is a heavy burden, and relatives often become exhausted themselves. The doctor explains how to communicate with the older person, how to respond to suspiciousness and nighttime restlessness, and where to find additional help. Online family sessions allow everyone to take part, even those who live in another city.
Myths and facts
MythPoor memory in old age is normal
FactSome slowing of thinking with age is natural, but a noticeable decline in memory that interferes with daily life is a reason for an evaluation. Some of the causes are reversible and respond well to treatment if they are found in time.
MythNothing can be done about dementia
FactAlthough most forms of dementia cannot be cured, treatment and proper care can slow decline, reduce anxiety, insomnia and aggression, extend the person's independence and make life easier for the family.
MythDepression in older people is just part of aging
FactDepression is not a normal part of aging. It worsens memory, sleep and the course of other illnesses. Treatment in older adults is effective, well tolerated when chosen correctly, and markedly improves quality of life.
How an online appointment works
- Message or callWrite on WhatsApp or call — our coordinator replies within minutes, day or night. You don't have to give your surname.
- Doctor and timeWe match you with a psychiatrist, addiction specialist or psychotherapist and agree on a time — often the same day.
- Video consultationA secure 50–60 minute video call: the doctor takes a detailed history and uses standardised scales if needed.
- Treatment planYou receive a clear summary, recommendations and a plan: what we do online and what needs an in-person visit or home call.
- Follow-upOnline follow-up sessions, messenger contact with your doctor, and treatment adjustments until you get a stable result.
Prices in Astana
| Online child/adolescent psychiatrist appointment | 17 000 ₸ |
| Consultation for parents | 15 000 ₸ |
| Follow-up online appointment | 13 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
You can book in Astana online or at one of two branches: 72 Bogenbay batyra St., Astana, 37 Petrova St., office 23, Astana. Our coordinator replies on WhatsApp within minutes at any time, and a doctor usually connects by video the same day; home visits are available too — all city districts and nearby settlements.
Confidential and private
Information about your visit, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We never share it with your employer, school or relatives without your consent; the only exceptions are those expressly set out by law. For an online consultation your first name is enough, video runs over a secure channel and nothing is recorded without your consent.
Questions and answers
How can I tell whether it's dementia and not just forgetfulness?
With ordinary forgetfulness, a person remembers later and keeps their everyday skills. In dementia, the problems grow and interfere with self-care, orientation and handling money. A definitive answer comes from an evaluation, but an initial assessment can be done online.
Can we consult a doctor without the older person?
Yes. Relatives can get advice on how to behave, what to watch for and which tests are needed. But to assess the condition, it is desirable for the patient to take part. If they refuse, the doctor will help you find the right approach to the conversation.
What is delirium and why is it dangerous?
Delirium is a sudden state of confusion, often with hallucinations and agitation. It is caused by infections, dehydration, medications and surgery. It is a medical emergency: call 103 or 112. Once the cause is treated, the mind usually clears.
Should medications be reviewed?
Absolutely. In older adults, many drugs — sleeping pills and some antihistamines and painkillers — can impair memory and cause confusion. The doctor will review the list and make recommendations; changes to treatment are made by the treating doctor, and medications must never be stopped on your own.
How should care at home be organized?
A consistent routine, clear cues — a calendar, labeled cupboards — good lighting and no rugs to trip over all help. The doctor will discuss safety, how to share the load among relatives and the signs that additional help is needed.
How often is follow-up needed?
When the condition is stable — every 1–3 months; when treatment changes or things get worse — more often. At Psychiatry Online, follow-up sessions take place online, sparing the older person trips, especially in the cold season when the streets are icy and there are blizzards.
Where can I be seen in Astana?
Online — from anywhere in the city or region. In person — at two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Both are open 24/7; home visits cover all city districts and nearby settlements.
Sources and methodology
This page was prepared by the Psychiatry Online medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) and APA (US) guidelines on the treatment of mental disorders
- WHO recommendations on telemedicine and digital health
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
