- Later life deserves the same care as any other.
Old Age Psychiatry
Mental health changes in later life are too often put down to ageing. Low mood, withdrawal, anxiety, sleep disturbance and changes in memory are not an inevitable part of getting older, and they are not something to simply accept.
PsycheTel Australia provides psychiatric assessment and treatment for older adults across Australia by secure telehealth, with family and carers involved where the person wishes.
What old age psychiatry covers
Old age psychiatry assesses mental health in later life, where physical health, medications, cognition, bereavement and social circumstances usually all interact. Working out which of those is driving what is the core of the work.
- Comprehensive psychiatric assessment for older adults
- Diagnostic clarification where a presentation is complex or has several possible causes
- Second opinion on an existing diagnosis or treatment plan
- Treatment planning, coordinated with the GP and any specialists involved
- Ongoing review and management
- Support and information for family and carers
- Reports and correspondence to the referring doctor
Who old age psychiatry is for
This service is for older adults whose mental health concerns relate to later life. That is about the nature of the presentation, not a birthday.
Old age psychiatry is usually the better fit where the concern involves memory or cognition, a change that has appeared later in life, physical illness and psychiatric symptoms together, or several medications that need reviewing as a whole.
An older adult with a long-standing condition such as ADHD, bipolar disorder or PTSD is usually better served by our adult psychiatry service. If you are unsure which applies, call 1300 652 935 and our team will point you to the right one.
What we assess and treat
- Depression and low mood in later life
- Anxiety, worry and agitation
- Sleep disturbance
- Grief and bereavement that has not eased
- Adjustment following retirement, illness, loss of independence or a move into care
- Mood and behavioural changes associated with cognitive decline
- Psychiatric symptoms occurring alongside physical illness
- Medication review where several medicines are involved
Late-onset changes in mood, personality or thinking are always worth assessing rather than attributing to age. Some have a treatable medical cause, and some are the first sign of something that benefits from early recognition.
Memory and cognitive concerns
Changes in memory, word-finding, planning or orientation are common reasons for referral, and they have many possible causes. Depression, anxiety, sleep disturbance, thyroid conditions, vitamin deficiencies, medication effects, alcohol, and neurodegenerative conditions can all produce similar changes, and telling them apart is the point of the assessment.
Being direct about how this works by telehealth: a psychiatric assessment of memory concerns can begin by video, and history from a family member adds a great deal. Some elements need more. Formal cognitive testing, physical examination, blood tests and brain imaging are arranged through your GP or a local service, and results are reviewed as part of your assessment. Where a full neuropsychological assessment or an in-person memory service is the right pathway, your psychiatrist will say so and recommend it.
Conditions with their own pages
Depression
Assessment, diagnostic clarification and treatment planning, including where previous treatment has not achieved what you hoped.
Anxiety
Assessment and treatment planning for persistent anxiety, worry and agitation.
Bipolar Disorder
Assessment, medication review and ongoing care, including transfer of care from a previous psychiatrist.
PTSD
Trauma-informed assessment, including where symptoms have surfaced or resurfaced in later life.
What an assessment involves
An initial consultation usually runs 45 minutes or longer. With the person’s agreement, a family member or carer is welcome to join, and their observations are often valuable.
Medication review is a larger part of assessment in later life than at any other age. Several medicines taken together can produce low mood, confusion, unsteadiness or sleep disturbance, and sorting out what is a side effect and what is a condition is often the most useful thing an assessment does.
Your psychiatrist will explore:
- Current symptoms, when they started, and how they have changed
- Physical health, recent illness and hospital admissions
- All current medications, prescribed and over the counter, and how they interact
- Sleep, appetite, energy and pain
- Memory, concentration and day to day functioning
- Alcohol and other substances
- Life circumstances, including loss, isolation, care arrangements and independence
- Previous psychiatric history and treatment
- Current safety
After the
assessment
Your psychiatrist will discuss their clinical opinion and a plan suited to the person’s situation. Depending on the findings, that may include medication review or adjustment where clinically appropriate, referral for psychological support, practical recommendations for daily living, information and support for family and carers, coordination with the GP and other treating doctors, and a schedule for review.
Treatment options vary depending on the individual’s circumstances, and suitability is assessed individually. Outcomes differ from person to person, and no particular result can be promised.
A report is provided to the referring doctor so care stays coordinated.
Family and carers
Families often notice a change before the person does, and often carry the appointment-making, the medication management and the worry.
With the person’s consent, family members and carers are welcome to join consultations, and their observations are treated as useful clinical information rather than an interruption. Where a person does not wish family to be involved, that is respected.
If you are a carer and unsure how to raise a referral, call 1300 652 935 and our team will explain the pathway. The person being referred needs to consent to the appointment.
How online old age psychiatry works
Consultations are delivered by secure video anywhere in Australia (metropolitan, regional and remote), including Brisbane, Sydney, Melbourne, Perth, Adelaide, Hobart, Canberra and Darwin.
For older adults, telehealth removes travel that can be difficult, tiring or dependent on someone else’s availability. A family member can help set up the call and stay for it.
Being direct about the limits: telehealth suits assessment, review and ongoing management well. It does not suit physical examination, formal cognitive testing, or acute presentations. Where physical investigations or in-person review are required, these are arranged through the GP or a local service.
Telehealth is not appropriate for crisis or emergency care, and it is not suitable where someone is acutely confused or unwell.
Referrals, fees and Medicare
A valid referral is required to claim a Medicare rebate for a psychiatrist consultation. A GP referral is the usual pathway, and a geriatrician or other specialist can also refer.
Consultation fees and the Medicare rebate applying to each consultation type are published in full on our fees page.
Frequently Asked Question
What is old age psychiatry?
Old age psychiatry is the assessment and treatment of mental health conditions in later life, where physical health, medications, cognition, bereavement and social circumstances usually interact. It covers mood, anxiety, sleep, grief and cognitive concerns.
Can an older adult see a psychiatrist online in Australia?
Yes. Assessment, review and ongoing management can be delivered by secure video anywhere in Australia. A family member can help set up the call. Telehealth is not suitable for physical examination, acute confusion, or crisis care.
Can a family member or carer join the consultation?
Yes, with the person’s consent. Observations from family and carers are often valuable, particularly where a change has been gradual.
Do I need a referral?
A valid referral is required to claim a Medicare rebate for a psychiatrist consultation. A GP referral is the usual pathway.
My parent is on several medications. Can you review them?
Medication review is a core part of old age psychiatric assessment. Several medicines taken together can produce low mood, confusion or sleep disturbance, and separating side effects from a condition is often the most useful part of an assessment. Any change is coordinated with the GP.
Isn't low mood just part of getting older?
No. Depression and anxiety in later life are conditions, not an inevitable part of ageing, and they respond to assessment and treatment in the same way they do at any other age.
If you are in immediate danger, call 000. For 24 hour crisis support, contact Lifeline on 13 11 14. PsycheTel Australia is not a crisis service and does not provide emergency or after-hours care.Group therapy items and family/carer items are also available under Better Access where clinically appropriate. Ask during your consultation
Book an old age psychiatry consultation
Secure telehealth consultations with AHPRA-registered consultant psychiatrists, available Australia-wide
