Inside, Inside the O' Briens

I just finished reading the New York Times Bestseller Inside the O' Briens by Lisa Genova. This book takes us inside the lives of Joe O' Brien, his wife Rosie, and his four kids (JJ, Meghan, Katie, and Patrick). Joe has just been diagnosed with Huntington's disease. The book highlights the devastating emotional effects the disease causes. One thing I think the book did a great job of was showing us how much the diagnoses affected those around Joe, really going into depth about how the possibility of getting the disease affected each one of his kids. The book was very deep and so sad at some parts it was hard to read, but unfortunately that is the ultimate reality of what this terrible disease does. As we have been learning about Huntington's disease in class, Inside the O' Briens really deepened my understanding of what it is, what the symptoms and prognosis are and how important a good social support system is.

As part of class we did an occupational profile on Joe which can be seen below:

Occupational Profile

Joe O' Brien, DOB: N/A
Report Date: April 22, 2018
Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)
Mr. O’Brien, a middle-aged male, has recently been diagnosed with Huntington’s disease. He is concerned about performing his duties as a cop with the Boston Police Department, being a good husband to his wife Rosie, father to his 4 children and future grandfather.
Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)
Mr. O’Brien is a successful police officer, good at his job. He takes pride in being a good father, teaching his children right from wrong. He usually walks their dog, Yas, every morning. Due to the prognosis of Huntington’s disease, the client is worried about how the symptoms are going to affect him in these occupations. The motor deficits and chorea associated with Huntington’s is going to make it hard to work as a police officer for much longer. It will be good for the client to walk Yas for as long as he can with appropriate supervision.
Personal interests and values (p. S7)
The client enjoys Sunday family supper with the family, watching the Red Sox games, going to his daughter Meghan’s dance performances, doing yoga with his daughter Katie, and drinking beers with his buddies Tommy and Donnie from the force.
The client’s occupational history/life experiences
N/A
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)
Mr. O’ Brien lives in a three-story house, with almost everything he needs on the first floor. The sidewalks and streets outside are uneven creating a hinderance when walking Yas. The client is working almost all the time. The client is on his feet for long periods of time at his job and struggles to stand still when he needs to. When not working, the client eats with his family, drinks one or two beers, and enjoys Boston sports with his two sons and friends. About 7 years ago, the client’s wife noticed Joe was not the same, his temper was out of control. He just was not the same person. A doctor’s visit was prompted by Joe’s friend Donnie calling asking if Joe was okay. A genetic testing was done revealing he had Huntington’s disease. The doctor has prescribed medications to reduce the effects of the symptoms.

Aspects of the client’s environments or contexts, as viewed by the client (p. S28)
Supports to Occupational Engagement:
Barriers to Occupational Engagement:
Physical
Hand Rails on the stairs
Plastic cups- no glass
Standing for long periods of time
Police reports
Social
Client has a good family and friend support system.
Emotional stability of family is a concern due to Joe and Meghan testing positive for the genetic gene for the disease
Co-workers assuming he is an alcoholic or using drugs
Antics of his son Patrick
Cultural
Practicing Catholic
The values that come with being a cop
Personal

Client has had the disease for about 7 years so the symptoms are worsening
Temporal


Virtual
Television to watch the Red Sox
Telephone


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)
The client’s main overall goal is to stay strong for his family and fight Huntington’s disease as best as he can. Mr. O’ Brien wants to maintain his skills for as long as he can, being able to work for a little longer. As part of therapy we will work on preventative activities to prepare for future symptoms.  


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