Geriatric Psychiatry in Michigan — Telehealth Psychiatric Care for Older Adults. Covered by Medicare.
Skye Mental Health provides telehealth psychiatric evaluation and medication management for older adults across Michigan.
Darla Dane, PMHNP-BC — a board-certified Psychiatric Mental Health Nurse Practitioner with extensive clinical experience in geriatric psychiatry, including direct care in skilled nursing and long-term care settings — evaluates and treats depression, anxiety, grief, dementia-related behavioral symptoms, and cognitive decline-associated psychiatric conditions in older adults.
Medicare (Part B; also known as Straight or Legacy Medicare) is accepted, along with most major Michigan Medicare Advantage insurance plans such as Plus Blue Medicare Advantage Plan by Blue Cross Blue Shield.
New patients are typically seen within approximately 3 days. All appointments are conducted by video via Zoom — no driving required.
Why geriatric psychiatry is different — and why it matters?
Psychiatric care for older adults is not the same as psychiatric care for younger patients. The aging brain and body respond to psychiatric medications differently — what works predictably in a 40-year-old can produce serious side effects, dangerous drug interactions, or inadequate therapeutic response in a 75-year-old. Kidney and liver function slow with age, altering how medications are metabolized. Polypharmacy — the simultaneous use of multiple medications that is common in older adults — creates interaction risks that require careful clinical management.
At the same time, the psychiatric conditions that affect older adults are frequently underdiagnosed and undertreated. Depression in older adults is often dismissed as a normal response to aging. Anxiety is attributed to personality rather than recognized as a treatable condition. Behavioral changes associated with cognitive decline — agitation, sleep disruption, paranoia, emotional dysregulation — are managed with the wrong medications or left unaddressed entirely because the clinician does not have the specialized training to navigate the intersection of psychiatric symptoms and cognitive change.
Darla Dane has spent a significant portion of her clinical career working directly with older adults in skilled nursing and long-term care settings. She understands the complexity of geriatric psychiatric presentation — how depression looks different at 80 than it does at 40, how grief and late-life adjustment interact with cognitive decline, and how to manage psychiatric medications in older adults safely and effectively. That clinical background is what makes her approach to geriatric psychiatry different from a general psychiatric provider seeing occasional older patients.
Conditions evaluated and treated in older adults at Skye
Depression in older adults
Depression is the most common psychiatric condition in older adults and one of the most consistently undertreated. It frequently presents differently than depression in younger patients — less visible sadness, more physical complaints, withdrawal, cognitive slowing, and loss of interest in activities — in ways that are often attributed to aging rather than recognized as a treatable condition. Late-life depression responds to psychiatric treatment including medication, and early intervention significantly improves quality of life and functional outcomes.
Anxiety in older adults
Anxiety disorders are highly prevalent in older adults and are frequently missed because they present alongside physical health conditions that explain or mask the symptoms. Generalized anxiety, health anxiety, and panic symptoms in older adults are all treatable psychiatric conditions. Medication management for anxiety in older adults requires particular care — benzodiazepines carry significant risks in aging patients including falls, cognitive impairment, and dependency — and selecting the right medication approach requires geriatric-informed clinical judgment.
Dementia-related behavioral symptoms
Cognitive decline and dementia frequently produce psychiatric and behavioral symptoms — agitation, aggression, sleep disruption, paranoia, emotional dysregulation, and depression — that significantly affect quality of life for the patient and create profound stress for family caregivers. Darla evaluates and treats these psychiatric symptoms in patients with cognitive decline, working to reduce behavioral disturbance and improve daily functioning and comfort. Skye does not diagnose dementia — that is the appropriate role of a neurologist or geriatrician — but the psychiatric symptoms that accompany cognitive decline are within Darla's clinical expertise and are among the most impactful areas where psychiatric intervention improves quality of life.
Grief and late-life adjustment
The losses that accumulate in older adulthood — the death of a spouse, siblings, and friends; loss of independence; transition from a long-time home; physical health decline — are among the most significant psychological stressors a person faces. When grief becomes prolonged, when adjustment to major life change produces persistent depression or anxiety, or when an older adult is struggling to find meaning and motivation in the context of significant loss, psychiatric evaluation and medication management can be a meaningful part of support alongside other care.
Cognitive decline-associated psychiatric symptoms
The early and middle stages of cognitive decline frequently produce psychiatric symptoms — depression, anxiety, irritability, apathy, and sleep disruption — that are distinct from the cognitive changes themselves and are directly treatable. Addressing these symptoms psychiatrically does not reverse cognitive decline, but it substantially improves quality of life, reduces caregiver burden, and helps older adults and their families navigate this stage with greater comfort and stability.
Medication management for older adults
Psychiatric medication management in older adults requires a fundamentally different approach than in younger patients. The principle of starting at lower doses, titrating more slowly, and monitoring more carefully reflects the pharmacokinetic reality of the aging body — not excessive caution. Drug-drug interactions are a constant clinical concern in patients managing multiple conditions. Darla's geriatric psychiatric background means she approaches medication decisions with this complexity as a starting assumption, not an afterthought.
10 signs an older adult may need geriatric psychiatric evaluation
1. Persistent low mood that has lasted weeks or months
Depression in older adults is not a normal or inevitable part of aging. Persistent sadness, emptiness, hopelessness, or a loss of pleasure in activities that previously brought enjoyment — lasting more than two weeks — warrants psychiatric evaluation regardless of age.
2. Withdrawal from social contact and previously enjoyed activities
An older adult who has stopped calling family members, lost interest in hobbies, declined social invitations, or become increasingly isolated may be experiencing depression or anxiety rather than simply "slowing down." Social withdrawal is one of the most consistent early signs of untreated late-life depression.
3. Anxiety or worry that has become constant or disabling
Persistent worry about health, finances, family, or safety that consumes significant mental energy, produces physical symptoms, or prevents normal daily functioning is a treatable anxiety disorder — not a reasonable response to the challenges of aging.
4. Behavioral changes that seem out of character
Increased agitation, irritability, suspiciousness, or emotional outbursts in an older adult who was previously calm and even-tempered may reflect psychiatric symptoms associated with cognitive decline or an untreated mood disorder. These changes are treatable and should not be accepted as inevitable.
5. Sleep that has significantly changed
Difficulty falling asleep, frequent waking, very early morning waking, or sleeping excessively during the day — particularly when accompanied by mood changes — are common presentations of late-life depression and anxiety that respond to psychiatric treatment.
6. Significant change in appetite or unexplained weight loss
Depression in older adults frequently manifests as appetite suppression and weight loss before emotional symptoms are recognized. When a primary care workup has not found a physical explanation, psychiatric evaluation is appropriate.
7. Grief that has not lifted after many months
Grief following the loss of a spouse, close friend, or family member is normal. Grief that does not begin to lift after many months, that produces persistent depression or functional impairment, or that is complicated by additional losses warrants psychiatric evaluation and support.
8. Confusion or cognitive changes accompanied by mood or behavioral symptoms
When cognitive changes — memory lapses, confusion, difficulty with daily tasks — are accompanied by depression, anxiety, agitation, or sleep disruption, the psychiatric symptoms require their own clinical attention. Treating only the cognitive changes while leaving the psychiatric symptoms unaddressed significantly reduces quality of life.
9. Caregiver or family members noticing changes the patient does not report
Older adults frequently underreport psychiatric symptoms — either because they normalize them as part of aging, because they do not want to worry family members, or because cognitive changes affect their ability to accurately describe their own experience. Adult children and caregivers who notice changes in mood, behavior, or personality in an older family member are often the most reliable reporters of clinically significant change.
10. Psychiatric medications that are not working or causing concerning side effects
An older adult who has been prescribed psychiatric medication by a primary care physician or non-specialist and is not experiencing adequate benefit — or who is experiencing side effects including cognitive impairment, excessive sedation, or falls — may benefit from a geriatric-informed psychiatric evaluation to assess whether the current medication approach is appropriate for their age and medical complexity.
Darla Dane, PMHNP-BC, is Skye's specialist in psychiatric care for seniors. Here is how she approaches your loved ones care.
Older adults are among the most underserved patients in psychiatric care. Their symptoms are normalized, their medication needs are misunderstood, and the psychiatric dimension of cognitive decline is frequently overlooked in the rush to address the cognitive changes themselves.
I have spent a significant part of my career working directly with older adults — in skilled nursing facilities, in long-term care settings, and now in telehealth — and what I know from that experience is that psychiatric intervention at this stage of life makes a real difference. Not just for the patient, but for the family members who are trying to support them. Treating depression, anxiety, and behavioral symptoms in an older adult does not turn back time. But it can meaningfully improve the quality of the time they have — and the quality of life of everyone around them.
Darla Dane, PMHNP-BC
Board-Certified Psychiatric Mental Health Nurse Practitioner at Skye Mental Health
Why choose Skye Mental Health for geriatric psychiatric care
Specialist clinical experience in geriatric psychiatry
Darla Dane's background includes direct clinical work with older adults in skilled nursing and long-term care settings across multiple facilities. Geriatric psychiatric presentation — the way depression, anxiety, and behavioral symptoms manifest in older adults, and the way psychiatric medications interact with aging physiology — is not theoretical knowledge for her. It is clinical experience accumulated across years of direct patient care.
Medication management designed for older adults
Darla's approach to psychiatric medication in older adults reflects the pharmacokinetic reality of aging — lower starting doses, slower titration, careful monitoring for drug interactions, and a conservative approach to medication classes that carry elevated risk in older patients. This is not the same approach used for younger adults, and it should not be.
Telehealth that removes the access barrier
For older adults with limited mobility, those who no longer drive, or those living in areas of Michigan without convenient access to specialist psychiatric care — telehealth removes the single largest barrier to consistent psychiatric treatment. Appointments happen from home, on a phone or tablet, without the physical and logistical burden of travel.
Appointments within approximately 3 days
Access to a geriatric psychiatry specialist in Michigan typically involves a long wait. At Skye, new patients are typically seen within approximately 3 days of requesting an appointment.
Family involvement welcomed and encouraged
For older patients who benefit from family support in their care, Darla welcomes the involvement of adult children and family caregivers in the evaluation and ongoing treatment process. Geriatric psychiatric care rarely happens in isolation from the family system, and Skye's approach reflects that reality.
Medicare and Medicare Advantage accepted
Skye accepts Original Medicare and a comprehensive range of Medicare Advantage plans, making specialist geriatric psychiatric care accessible for older adults without significant out-of-pocket expense.
Frequently asked questions about geriatric psychiatry at Skye Mental Health
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Yes. Skye Mental Health accepts Original Medicare Part B for psychiatric evaluation and medication management. Medicare Advantage plans currently accepted include Blue Cross Blue Shield Medicare Advantage and Plus Blue Medicare Advantage. Priority Health Medicare Advantage, Aetna Medicare Advantage, UnitedHealth Medicare Advantage, Blue Care Network Medicare Advantage, and HAP Senior Plus are pending approval and will be accepted within approximately 30 days. Contact Skye to confirm current coverage status for your specific plan.
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Skye Mental Health evaluates and treats depression in older adults, anxiety disorders, grief and late-life adjustment difficulties, dementia-related behavioral symptoms including agitation and sleep disruption, cognitive decline-associated psychiatric symptoms, and psychiatric medication management for older adults. Skye does not diagnose dementia — that is the appropriate role of a neurologist or geriatrician — but the psychiatric symptoms that accompany cognitive decline are within Darla Dane's clinical expertise.
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Yes. Skye's telehealth appointments are conducted via Zoom and can be accessed on a smartphone, tablet, or computer. For older adults who are unfamiliar with video technology, the setup is straightforward and Skye's team can walk your family through the process before the appointment. Adult children and family caregivers are welcome to participate in the appointment and can assist with the technical setup.
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Psychiatric medication management in older adults requires a different approach than in younger patients. The aging body metabolizes medications more slowly, meaning standard doses can produce stronger effects or accumulate to problematic levels. Drug-drug interactions are a constant concern in older adults managing multiple conditions. Certain medication classes — particularly benzodiazepines — carry elevated risks in older patients including falls, cognitive impairment, and dependency. Darla Dane's geriatric psychiatric background means she approaches medication decisions with this complexity as a starting assumption.
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Skye Mental Health does not diagnose or treat dementia itself — that is the appropriate role of a neurologist or geriatrician. However, cognitive decline and dementia frequently produce psychiatric symptoms — depression, anxiety, agitation, sleep disruption, paranoia, and emotional dysregulation — that are within Darla Dane's clinical expertise and respond to psychiatric treatment. Addressing these psychiatric symptoms improves quality of life for the patient and reduces caregiver burden significantly.
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You can schedule directly at skyementalhealth.com/get-started. Complete the short intake form — either as the patient or on behalf of a family member — and Skye's team will verify your insurance and confirm your appointment. New patients are typically seen within approximately 3 days. You can also call or text 248-587-8267 or email hello@skyementalhealth.com.