Inside the O'Briens

       "Inside the O'Briens" is a novel that follows the O'Brien family as they cope with their father's recent diagnosis with Huntington's disease and their genetic disposition to the disease. When a parent is diagnosed with Huntington's disease, their children each have a 50/50 chance of inheriting the disease as well. In reflecting on this book, what stuck out to me the most was how this disease affects each member of the family in such different and complex ways. Joe is having to accept the new diagnosis, cope with the realization that his mother also died from disease rather than alcohol, and cope with how his progressive and death will affect his family emotionally and financially. His kids are mourning the impending progression of this disease they will witness in their father while simultaneously questioning everything about their own lives if and when they learn they are carriers. Their is heartbreak, resentment, loss, guilt, and many other hard emotions the family has to work through. As a clinician working with a client diagnosed with Huntington's disease, I have more of a window into how this affects the client and his or her whole family. I know I will need to approach the family and client with sensitivity, compassion, and just overall quickness to listen and ask questions as we together proceed in therapy.   

Occupational Profile

Joe O'Brien 

44 years old

April 21,2018

	Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	·         Client has recently been diagnosed with Huntington’s and has noticed difficulty with driving, coordination, control of voluntary movement, and mood outbursts.
	Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)	·         Client has been successful at his job as a cop and his role as a father. His fidgeting, trouble with driving, time management, and executive functioning has proven to be barriers in his job. ·         He has been successful as a parent and husband. However his mood outbursts have added stress to his relationships. ·         Client is successful in ADL’s but is noticing some decline with executive functioning
	Personal interests and values (p. S7)	·         Client loves baseball, values being there for kids (although his job schedule often prevents this), and working to keep his city safe.
	The client’s occupational history/life experiences	·         He grew up with a mother who he just recently learned had Huntington’s rather than a drinking problem. ·         Client currently lives with in a 3 story home with his grown children and daughter-in-law residing on floors above. ·         His wife reports several years of temper outbursts and personality changes. ·         Clients roles include work as a police officer, being a husband, father, and brother.
	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’s routine changes daily due to his job as a police officer. He often has required to work long hours. He makes efforts to attend family events such as his daughter’s performances. However, either his job or increasing forgetfulness prevents him from attending. ·         Client admits to having some unhealthy eating and drinking habits ·         Client is a big baseball fan, father, police officer, and husband
	Aspects of the client’s environments or contexts, as viewed by the client (p. S28)	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
	Physical	He has a good, stable place of residence; lives on first floor	His neighbors and overall city population has changed due to housing value increase which sometimes causes him stress
	Social	He has supportive wife and children who live together in the same house but on separate floors.	His family has really struggled with diagnosis due to their genetic disposition. Client struggles with guilt over this.
	Cultural	Culture of his home values family time and supporting him through this diagnosis. Client states that returning to his faith has been helping for him in this new diagnosis.	Culture of his work: having to be tough, not admit “weakness”. His irish culture promotes his stubbornness.
	Personal	Client is 44 years old, working for 25 years, and married for 26 years. He has valued the loyalty to his career and family.	Client is having a hard time accepting the disease and how it limits him.
	Temporal	He is closer to retirement age.	Client wants to work a little longer to make sure his wife will be ok financially when he can no longer work.
	Virtual	Client enjoys watching TV and using a computer to navigate work and home tasks.	Client is having problems using technology as disease progresses.
	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 wants to live his life to the fullest as a father, husband, and new grandfather. He wants to maintain his overall independence in self-care activities, continue to work, and attend baseball games and family events.