Inside the O'briens

I really enjoyed reading Inside the Obriens by Lisa Genova. I have heard of HD before, but I never really knew how awful this disease really is until learning about it in Neuro aspects. This book is a great representation of HD, and the repercussions this awful disease has on a family dynamic. This book really hit close to home for me because my dad is a Memphis police officer, and Joe Obrien, who is the father diagnosed with HD, is a Boston police officer. I think this helped me empathize with the family a little more than I would have otherwise. Reflecting on my thoughts of the book the thing that struck me the most was the progression of Katie's and Joe's relationship. Katie always felt less than her sister Meghan, so I think it was important for her to develop this special relationship with her dad during this tough time. Towards the end of the book Joe started doing yoga with Katie, and this time together meant so much to both of them. My greatest take away from this book is that life doesn't stop for anybody. Yeah Katie, Meghan, JJ, and Patrick all had a 50/50 chance of developing HD in there 30s-40s, but accidents happen everyday, and even if they didn't have HD something would kill them eventually. We never know when a day could be our last, and I think the HD probability for Katie made her realize she needs to live her life to the fullest now, and worry about the future when it comes. I hate inconclusive endings, but with this book I in a way enjoyed that it didn't end concretely. I can imagine Katie and the rest of the O'briens living their lives out happily and with no regrets.



Occupational Profile
Client: Joe O’Brien, 44 YO

Date of Report: April 18, 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)
Client has recently been diagnosed with Huntington’s disease. He is experiencing severe mood swings, chorea, and problems staying on task and organized.
Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)
·      Parenting
- Barriers/Challenges: The client has always enjoyed being a father, but he now experiences extreme guilt from passing on his HD gene to his children.
·      Working
- Barriers/Challenges: Client is a Boston police officer and he is having trouble staying on task at work, and he is also having trouble writing up his reports.
·      Socializing:
- Barriers/Challenges: The client is finding it difficult to socialize like he used to because he is self-conscious of his symptoms (chorea and mood swings).

Personal interests and values (p. S7)
·      He wants to be the father his children need in this tough time.
·      He wants to be able to work at least in some capacity as a police officer.
·      He wants to be able to socialize without being self-conscious of his symptoms.
The client’s occupational history/life experiences
Client lives in Charlestown, which is a neighborhood of Boston. He has lived there his entire life. He lives with his wife and adult kids in a triple-decker. He, Rosie, and their youngest Patrick live on the first floor. His son JJ and his wife Colleen live on the second floor, and then his two daughters Meghan and Katie live on the third level. Joe is a Police officer for the Boston police department, which he takes great pride in. The things he cares about most in life are his wife, kids, and Boston. The client is used to being in complete control and especially having great self-control, so his HD diagnosis is making him feel more out of control than he has ever felt in his entire life. He always thought he mom was an alcoholic and drank herself to death, but he just recently
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)
Roles:
Husband
Father
Grandfather
Police officer

Routine:

·      Client’s daily life revolves around his role as a Boston Police officer. He spends many early mornings and late nights going to work. He works a lot of additional overtime details along with his regular shifts, so his schedule is really unpredictable.
·      Most mornings, client will walk his dog Yaz, so this is a part of his daily routine.
·      Every Sunday night his wife Rosie cooks for the entire family so this is something he will attend if he does not have work.
·      Joe loves the Boston Red Sox so anytime there is a game on TV he must watch.

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
The client lives on the first floor of his triple-decker home.
Where the client lives he sometimes has to walk blocks away from his home.
Social
The client has a good support system, who understand when he has mood swings it is the HD talking and not him.
The way the client’s body moves and his anger outbursts aren’t socially acceptable to people who don’t know he has HD.
Cultural
none
Being a Boston police officer it is culturally unacceptable for the client to appear drunk when policing (his symptoms make him appear drunk)

Personal
Client is a 44-year-old male.
Client’s mother died of HD and this is now his fate.
Temporal
Client has just recently been diagnosed with HD, so he has a good 10-15 years of life.
The client only has a certain amount of years depending on when his symptoms started.
Virtual
none
none
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 hopes to be able to be the father his children need in this difficult time of their lives.
-       Client hopes to be able to continue to work in the Boston police department in some fashion to be able to provide for his family.
-       Client hopes to be able to participate socially with friends and family without his HD symptoms getting in the way.




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