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O'Brien Occupational Profile/Review

Occupational Profile
Client demographics: Joe O’Brien, 44 years old, 04/21/2018

Client Report
Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)
Joe is seeking OT services because he was recently diagnosed with Huntington’s Disease and he would like to slow the progression of his symptoms. Joe has issues with his temper, being still, holding objects, and drinking from a normal glass.
Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)
Joe enjoys: Working as a police officer, spending time with his family, drinking with friends, and watching baseball.

The main barrier to the activities he enjoys is the chorea. It causes him to move almost constantly and it also causes him some embarrassment.
Personal interests and values (p. S7)
Interests: Socializing, baseball, drinking with friends.
Values: Family and justice.
The client’s occupational history/life experiences
Joe was diagnosed with HD 1 month ago. He says that the doctor who diagnosed him encourage him to start therapy services to get ahead of the symptoms of HD. He says that the tries to stay on top of his game by doing yoga with his daughter. He has been a police officer for 25 years and wonders how HD will impact his job. He also wonders how the disease will impact his family physically, because they all live together in their triple decker home (8 people including Joe) and 2 of his 4 kids are gene positive, and psychologically. Joe knows he got the disease from his mother.
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)
Joe’s daily routine: Wake up, get ready for work, drink coffee/eat breakfast, drive to work, work, drive home, change clothes, eat dinner with family, drink beer, watch baseball, go to bed.
Joe sees himself as the provider and protector of his family and is worried how HD will change that.
Rituals: Family supper on Sunday and watching baseball.
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
Has lived in the same house all of his life.
He lives with his wife, 4 children, daughter in law and grandchild, so space is rather tight, which is difficult because of Joe’s almost constant chorea.
Social
Loves watching baseball.
Finds it difficult to sit still through a game.
Cultural
Is proud of his Irish heritage.
Was ashamed of his mother and her legacy before he realized that she had HD and was not a drunk.
Personal
Joe is being proactive about seeking therapy services.
He knows that therapy will only slow the progression of his symptoms.
Temporal
N/A
N/A
Virtual
N/A
N/A
ClientGoals
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)
Joe says that he would like to remain in his home as long as safely and realistically possible. He is open to a wide range of therapy options and being included in clinical trials. He is aware that therapy will only slow the progression of his symptoms, but he is willing to do anything to maintain his quality of life and spend it with his family. He is worried about the psychological effects that his disease will have on his wife and kids, considering that 2 of his 4 kids are gene positive for HD.



Inside the O'Brien's is a book by Lisa Genova that tells the story of a family plagued by Huntington's Disease. The O'Brien's are a good old fashioned Irish Catholic family that lives in Charleston, South Carolina. Joe and Rose live in the house his parents willed to them with their four children, a daughter in law and grandson. Joe is a normal, Boston cop. Proud to serve and protect his city and family. Rosie begins to notice that Joe is developing more of a temper, would randomly drop things and could not stop moving. After some begging, Rosie convinced Joe to go to the doctor. Reluctantly, Joe went and a few appointments and a blood test later, he was diagnosed with Huntington's Disease. It takes Joe and Rosie a couple of months to process Joe's diagnosis, then they tell their children. Joe is extremely worried that his children will have Huntington's, because there is a 50% chance that he passed the gene on to them. JJ and Meghan take the genetic test and find out that they are gene positive, meaning that they will develop Huntington's at some point in their life. Patrick has decided not to get the test and Katie is on the fence. Joe's symptoms slowly become more apparent and he is forced to quit his job. Joe contemplates suicide because he thinks it would be easier on his family, but is convinced by Katie that he needs to show his children how to bravely live with Huntington's. 

Despite this book being sad overall, I thought it was informative about Huntington's and the havoc it can cause families. By attaching Huntington's to a person, with a story, with a family, Genova really makes the reader connect to the O'Brien's. It made me wonder what I would do if I was in the situation the O'Brien children are in and it made me wonder what secrets are lurking in my genetics?

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