We want Tasmanians who live with hoarding or have challenges maintaining a healthy home to have access to effective support that enables them to age well at home.

Treasured Lives shows us how this can happen by:

• Understanding what we know about how many older Tasmanians are living with these challenges;
• Understanding what it’s like for their families, carers and the services that work with them, and what they need to support people living with these challenges;
• Beginning to understand what it’s like for people who live with these challenges, through the perspectives of the people who try to support them;
• Looking at how people are supported elsewhere in Australia and internationally.

Treasured Lives received ethics approval to talk directly to older Tasmanians who live with these challenges. Unfortunately, the Tasmanian Department of Health does not currently have the capacity to work on this with us. We strongly recommend that older people who live with these challenges are included in any future consultations about supports and services.

For more information about the project please contact the Researcher, Lindsey Fidler, on lindseyf@anglicare-tas.org.au.

Project governance

This research project is being overseen by a Research Reference Group. It includes members from:

• Carers Tasmania
• COTA Tasmania
• Flourish
• Mental Health Families and Friends.
• Australian Government Department of Health (Aged Care Programs)
• Tasmanian Department of Health – Mental Health, Alcohol and Drug Directorate and Community Care Reform
• Tasmanian Department of Communities
• Housing Tasmania
• Primary Health Tasmania
• Local Government Association of Tasmania
• Anglicare Tasmania
• Baptcare
• Family Based Care Tasmania
• RSPCA
• Tas Fire Service
• Huon Valley Council

For more information about the project please contact the Researcher, Lindsey Fidler, on lindseyf@anglicare-tas.org.au .

Ethics

The project has been approved the University of Tasmania’s Human Research Ethics Committee. Project ID 18686.  If you have a complaint to make about how this research is being conducted please contact Research Integrity and Ethics Unit: human.ethics@utas.edu.au | Phone: (03) 6226 6254.

If you have a complaint to make about any other matter relating to the project, please contact: Mary Bennett, SARC Coordinator, on email: maryb@anglicare-tas.org.au.

Hoarding is a recognised psychiatric disorder involving challenges with acquiring, sorting and/or discarding items or animals. It may lead to living spaces being unsafe and difficult to use for their intended purposes, such as sleeping, cooking and bathing.  People with such challenges hold significant attachment to items, which makes discarding difficult.  It can also lead to people being socially isolated.

Challenges maintaining a healthy home describes an unsanitary environment that has arisen from extreme or prolonged neglect and poses health and safety risks to the people and/or animals living there, as well as others within the community. It could be because there is an accumulation of rubbish, decomposing food, grime, dust or mould. This can lead to health challenges for those who live there.

‘Older Tasmanians’ in Treasured Lives are people aged over 50, or 45 if they are Aboriginal or Torres Strait Islander.

It is estimated that 2.5% of the adult population live with hoarding. This means about 5,000 older Tasmanians might have hoarding behaviour.

It is estimated that one household with hoarding could cost the government over $56,000 in emergency care and legal matters. If that household is given effective specialist supports, the cost falls significantly.

This means the Tasmanian government could be spending over $200m on older Tasmanians living with hoarding or CMHH.  If resources were spent on effective specialist supports, we estimate the cost would fall to under $800,000 per year, with additional supports through Primary Health Tasmania.

Treasured Lives has looked at what Tasmania needs to deliver effective support for these households. The first phase of the project looked at the experiences and needs of families and carers. The second phase has looked at how services currently try to provide support and deal with problems. Together they provide Tasmania’s first in-depth insights into hoarding and CMHH.

In the first part of Treasured Lives, we talked to the families and carers of older Tasmanians who have challenges with hoarding or maintaining a healthy home.

The report focuses on what we know about people who live with this issue and the experiences of their families and carers. It examines how to help families and carers and what’s being done interstate and internationally.

This part of the research explored what Tasmanian services need to help older people who have challenges with hoarding or maintaining a healthy home.

It looked at aged care and disability support, and other services like housing and mental health. It also explored the role of statutory agencies such as emergency services, local government environmental health and animal welfare organisations.

Staff working in these areas were interviewed to ask what it’s like for them. They reported that they had nowhere to refer their clients to and were sometimes unable to work with them due to workplace health and safety issues. These are some of the most vulnerable older Tasmanians, but there is no safety net to help them age well.

The report also looked at policy, programs and practice in other parts of Australia and internationally that support people living with this issue, particularly older people.

We recommend the Tasmanian Government and Primary Health Tasmania invest in:

1. a policy and a practice framework, developed and implemented by a designated lead state government agency
2. a positive community education campaign
3. regional Tasmanian collaboration and services which include:
   • multidisciplinary professional networks for local case management and support
   • specialist case management
   • specialist clinical, psychosocial, practical and peer supports for older people
   • specialist clinical, psychosocial, practical and peer supports for families and carers
   • a partnership response to critical incidents that leads to positive supports
   • services of last resort that can minimise client and environmental harm to levels within the risk tolerances of mainstream services
   • a workforce development plan
4. a digital hoarding and CMHH information hub.
5. testing the service design with older Tasmanians living with hoarding or CMHH.

To do this, we estimate that the Tasmanian government needs to invest about $3.3m over 5 years from 2022-23 to 2025-26. As well, Primary Health Tasmania would need to invest about $4.5m over the same period.

This investment would provide intensive supports for up to 90 people a year. It would also allow mainstream services to improve and expand their response to this group.

This would be a significant saving for the government and give Tasmanians living with hoarding or CMHH access to effective supports that enable them to age well at home by 2025.