Inside the O'briens

After reading Inside the O'briens, I learned a lot about how Huntington's Disease not only alters the person's life but everyone around them.  This book was an excellent depiction of what it is like to be diagnosed and have a family.  The book gave me a better understanding of how a person is diagnosed and made me think about all the aspects that go into deciding to get the genetic testing.  The book discussed in depth that there is still a chance to not know if you are positive or negative when getting genetic testing, which I assumed was a yes or no situation not a yes, no, and maybe situation.  The book depicted the harsh reality of having a parent diagnosed and learning you are at risk of it and what it looks like to plan a life after that.  I think this book is a must-read for anyone in a health profession in order to have a better understanding of HD and its emotional impact on a family.

Client Name: Joe O’brien (44 years old)                                                       Date: 4/21/18

OT Practitioner: Ashley Boehm

Occupational Profile

Client Report	Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	Client is seeking to OT in order to improve his ability to work on the Boston Police Department. Client is seeking help with recalling information for paperwork at work. Client is also seeking OT for remaining physically active in his job. Client is also seeking treatment to combat his short fuse form Huntington’s Disease.  Client is seeking service to work on financial management for his family and his medical needs.
	Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)	The client is successful in dressing, feeding, grooming, and working.  The client is able to get through the work day and submit reports, but it takes him longer than it used to. Some potential barriers to the client’s success in working is his chorea due to HD since there are times he needs to stand still or move in a specific direction.  The client has a potential barrier of getting his retirement from the Boston PD due to his health, causing him to struggle to provide for his family and his medical needs.  The client’s decline in motor abilities and control are potential barriers for his ability to take care of himself.
	Personal interests and values (p. S7)	Client is close to his wife and children.  He enjoys Sunday suppers with his entire family.  The client also enjoys spending time with his friends at a local bar and watching sports.  Joe is a big fan of the Boston Red Sox and enjoys attending/watching the games. The client is passionate about his work.  Client enjoys walking the family dog with his wife. Client has been raised Catholic and still practices aspects of the religion.
	The client’s occupational history/life experiences	Client was born and raised in Charlestown, which is within Boston, MA.  Client lost his mother at age 12 to Huntington’s Disease but was not aware it was HD until he was diagnosed.  Client believed his mother “drank herself to death” and avoided drinking more than 2 beers in a sitting.  Client was raised Catholic but does not attend mass.  Client is married to his “high school sweetheart” and has 4 kids (2 girls, 2 boys).  Client’s father passed away and left the childhood home to him and his sister.  Client does not keep in touch with sister.  Client’s children live on the other floors of the house and pay rent.  Client is a Boston Police Officer and enjoys his job.  Client was diagnosed with HD recently and has told his children.  Client is about to become a grandfather.
	Performance patterns (routines, habits, & rituals) – what are the client’s patterns of engagement in occupations and how have they changed over time? What are the client’s daily life roles? Note patterns that support and hinder occupational performance. (p. S8)	Client wakes up early to make role call at work.  Client has a habit of leaving his belongs out and his wife puts them away.  Then client has breakfast with his family that his wife has prepared.  Client then heads to work.  Many days the client works overtime, so he doesn’t get home till late.  When the client gets home he eats dinner and relaxes in his chair while watching tv.  Client is a father and husband. Also, the client is a police officer and a friend. Client has struggled with his temper and ability to complete paperwork for his job since being diagnosed. The client makes it a point to be back to 4pm Sunday supper with his family.  Client has had more sudden outbursts of movement since being diagnosed which are now a habit.
Context	Aspects of the client’s environments or contexts, as viewed by the client (p. S28)	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
	Physical	Lives in a 3-story house. Has a family dog who he walks around town.	His sudden movements make it hard to walk.
	Social	Client has a supportive family and wife. Client also has a friend who is supportive and helpful.	Client has temper outbursts that make it difficult for people to be around him at times.
	Cultural	Joe grew up Catholic and his wife attends mass every Sunday. Joes enjoys watching the Boston Red Sox.	Joe does not attend mass.   Joes works the Boston Red Sox games.
	Personal	Joe is determined to stay on the Boston PD. Client desires to stay active and alert as long as he can.	Client’s disease has its own rate that it occurs at meaning Joe cannot control it.
	Temporal	Joe is in his 40s but is still active and using his mind regularly.	Client is aging quicker due to diagnosis.
	Virtual	Client has a phone in order to stay in contact with family and friends.	Client is forgetful and leaves it places.
Client Goals	Client’s priorities and desired target outcomes (consider occupational performance – improvement and enhancement, prevention, participation, role competence, health & wellness, quality of life, well-being, and/or occupational justice) (p. S34)	Client desires to improve his motor abilities so he can remain active and work.  Client desires to work on his cognitive abilities so writing reports at work will not be as difficult and tedious. Client desires to work on money management so his family is provided for and secure when his medical bills get expensive. Client would like remain in his home as long as possible.