Reviewed byAigul Serikova, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F03
- Who provides care
- a psychiatrist (geriatric focus), together with a neurologist, a general physician and a clinical psychologist when needed
- Format
- psychiatrist home visits, appointments at our clinics in Almaty and Astana, online consultations for relatives and check-ins between visits
- Duration
- first assessment 60–90 minutes; finding treatment for behavioral symptoms takes several weeks; then follow-up every 1–3 months
- Confidentiality
- medical confidentiality, anonymous care, no entry in the state registry; information is shared only with legal representatives and as required by the law of the Republic of Kazakhstan
- When it is urgent
- sudden confusion over hours or days, a fall, high fever, refusing food and drink, dangerous aggression — call 103 or 112
- Outcome
- the cause of the decline is clarified, anxiety, aggression and insomnia are reduced, and the family has a care plan and an understanding of what to expect next
What to know
Most often it is not the patients themselves who contact us, but their adult children: Mom has started forgetting things, mixes up the days, walks around the apartment at night, accuses the neighbors of stealing, and no longer recognizes her grandchildren. The family gets exhausted and angry, and then feels guilty about that anger. I want to say right away: this is a normal reaction, and help is needed not only by the older person but also by those who care for them. Here, the psychiatrist is a doctor who helps the whole family go through this journey more gently.
Dementia is not “normal aging” but a syndrome in which memory, thinking, orientation and the ability to manage everyday life gradually decline. In ICD-10 it is coded F00–F03, and in ICD-11 6D80–6D86. The causes vary: Alzheimer’s disease, vascular disorders, dementia with Lewy bodies and frontotemporal degeneration. Importantly, some conditions that look similar are reversible: depression, vitamin B12 deficiency, thyroid disorders and medication side effects.
When an older person needs a psychiatric assessment
- forgets recent events and asks the same questions repeatedly within an hour
- gets confused about time, gets lost in a familiar neighborhood, cannot find the way home
- can no longer manage money, medications, the stove or household appliances
- has started suspecting theft, showing jealousy, or believing that strangers are in the apartment
- does not sleep at night, wanders, packs belongings to “go home”
- has become irritable, tearful, sometimes aggressive toward those who care for them
- sees people or animals that are not there, especially in the evening and at night
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
What causes dementia and what makes it worse
The most common cause is Alzheimer’s disease, in which memory for recent events is affected first and declines gradually. Vascular dementia is linked to strokes and chronically reduced blood flow to the brain, and it often progresses in a stepwise way. Dementia with Lewy bodies shows up as fluctuating attention, visual hallucinations and a particular sensitivity to antipsychotics. The type of dementia affects the choice of treatment, so it is important to clarify it together with a neurologist.
A sudden deterioration in a person with dementia almost always has an external cause: a urinary tract or chest infection, dehydration, constipation, pain, a new medication, a move, a hospital stay or a change of caregiver. This state is called delirium, and it requires finding and treating the cause, not simply giving a “sedative.” That is why the first thing I ask the family is what has changed in the last few days and which new medications have appeared.
How a psychiatrist’s visit to an older person works
You can start with an online consultation for relatives: the doctor asks how the person’s condition has changed and asks you to prepare a list of all medications, discharge summaries, test results and MRI scans. Then the psychiatrist comes to the home — in familiar surroundings, an older person is calmer and behaves more naturally. The doctor talks with them, runs short memory and attention tests, speaks separately with the family and draws up a plan for further tests, treatment and care.
Memory cannot be assessed and dementia cannot be diagnosed online, but changes in behavior can be discussed and care can be adjusted. Treatment at home is not possible in cases of sudden confusion with fever, after a fall with a blow to the head, refusal of food and drink, dehydration, sudden speech problems or weakness in an arm and leg — these are reasons to call 103 or 112 immediately, because it could be a stroke or a serious infection.
How we help
Diagnosis and ruling out reversible causes
The psychiatrist assesses cognitive function using standardized scales, asks how the symptoms have developed, orders blood tests (including vitamin B12 and thyroid hormones) and, when needed, refers the person for an MRI and to a neurologist. We also check separately for depression: in older people it often looks like memory loss, and it responds well to treatment.
Treating behavioral symptoms
Anxiety, insomnia, delusions of theft and aggression are the hardest symptoms for families. First, we look for the cause and try non-drug measures: a daily routine, better lighting, less noise and a review of the situations that trigger outbursts. Medications — anti-dementia drugs, antidepressants and, in selected cases, antipsychotics — are prescribed only by a doctor, cautiously and with regular review, as recommended by NICE and the WHO.
Family education and organizing care
We explain how to talk to a person with dementia: briefly, calmly, without testing their memory or arguing. We help set up a safe home: a pill organizer, notes, gas safety controls and a bracelet with contact details. We discuss how to share the load among relatives and bring in a caregiver, so that the main caregiver is not left alone.
Support for family caregivers
Caring for a person with dementia is a long-term burden, and caregiver burnout is very common. A psychotherapist or psychologist helps cope with exhaustion, guilt and the grief that is felt while the loved one is still alive. If the caregiver develops insomnia, anxiety or depression, the psychiatrist can help them too.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythForgetfulness in old age is normal
FactMemory does slow down slightly with age, but if a person can no longer manage everyday life, gets lost in familiar places and forgets recent events, that is a reason for an assessment. Some causes are reversible if you seek help in time.
MythNothing can be done about dementia
FactMost forms of dementia cannot yet be stopped, but it is possible to slow the decline, reduce anxiety, aggression and insomnia, extend the time the person can live at home, and make care much easier for the family.
MythA strong sedative will solve the problem
FactStrong sedatives increase the risk of falls and confusion in older people, and some types of dementia are especially sensitive to them. Treatment is chosen carefully, starting with finding the cause of the restlessness and using non-drug measures.
Prices: Dementia care
| Dementia care | 35 000 ₸ |
| Psychiatrist consultation at the clinic | 15 990 ₸ |
| Psychiatrist home visit | 35 000 ₸ |
| Follow-up visit, treatment adjustment | 12 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
Mom refuses to see a doctor. What should we do?
You don’t have to say “psychiatrist.” You can introduce the doctor as someone who will check her blood pressure, sleep and general well-being — many older people readily agree to such a home visit. A decision on involuntary treatment can be made only by a court, under the procedure established by the law of the Republic of Kazakhstan; this is resorted to only in exceptional cases.
How is a psychiatrist different from a neurologist in dementia care?
A neurologist usually focuses on clarifying the type of dementia, brain imaging and neurological symptoms. A psychiatrist deals with behavioral and emotional symptoms: delusions, hallucinations, anxiety, depression, aggression and insomnia. It works best when both specialists work together.
Can legal documents be arranged if a person has dementia?
Questions of legal capacity are decided in court under the law of the Republic of Kazakhstan, with a forensic psychiatric evaluation. Our psychiatrist can examine the person and issue a medical report on their condition, but this does not replace the forensic evaluation. Transactions and powers of attorney are best arranged while the person is still able to understand what they mean.
How often are follow-up visits needed?
While treatment is being selected — every 1–2 weeks, and some of these contacts can be held online with relatives. When the condition is stable, an assessment every 1–3 months is enough. An unscheduled visit is needed after any sudden change in behavior, sleep or appetite, or after a fall or hospital stay.
Is it anonymous?
Yes. Akalam observes medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System,” and you can receive care without being placed on a registry. We discuss the person’s condition only with the relatives chosen by the patient or their legal representative.
When is it time to consider a care home?
When safety and round-the-clock care can no longer be provided at home and the caregivers are at the limit of their strength. This is not betrayal; it is caring for every member of the family. We help assess what level of care is needed and prepare the older person for the move so that it goes with less stress.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy