HD OP report on the O'Brians

Joseph O’Brian

Age 43

Date of report: 4/20/18

Occupational Profile

	Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	Recently diagnosed with HD. Experiencing early signs/symptoms interfering with daily activities and job. Increased outbursts and temper, chorea interfering with relationships and ability to complete daily activities. Becoming a problem for his job.
	Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)	Father, police officer, husband, dog owner, well known citizen of the community, physically and mentally strong. HD prevents him from being able to do his job. Mood swings are interfering with his relationships. Chorea prevents him from safely doing physical labor.
	Personal interests and values (p. S7)	Being a good husband to his wife, a good father to his children (wants them all to be happy and successful). To be a good police officer; expresses how it is easy to let the job make you feel less for people after seeing such tragedies. Guilty pleasure is walking the family dog. Enjoys hanging out with his friends and cracking jokes.
	The client’s occupational history/life experiences	Police officer. Grew up in small community. Still friends with those he knew as a young child. Mother died of HD when he was young. Father died of cancer when he was an adult. Not in contact with sister.
	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)	Weekly Sunday dinner with family at 4:00. Lives on the bottom level of a three story house. Has to park on the street, sometimes blocks away from the house. Father of 4 and married; all are in their 20’s and live at home. Spends most of his time working as a police officer which is mentally and physically draining. Often works overtime and misses multiple family events because of long work schedule. Usually takes the dog for walks around town on Sundays when the family is at church and he doesn’t have work. Town has lots of hills
	Aspects of the client’s environments or contexts, as viewed by the client (p. S28)	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
	Physical	Enjoys walking family dog. In good physical shape before diagnosis. Goes on runs occasionally to clear head	A lot of the things he enjoys doing involves physical activity that he is losing the ability to do
	Social	Strong relationships with friends and family. Has a great support team	A lot of his friends are co-workers and he won’t be able to see them as much when not working. They also like to go to the bar and he doesn’t drink too much
	Cultural	Small community. All families know and look out for each other.	His community isn’t used to talking about their emotions. It’s a lot of weight to hold on his own.
	Personal	Has police training for crisis. Organizes thoughts and does well in fight or flight mode.	Feels pressure to make sure family is well taken care of. Also feels guilt for passing on HD to children
	Temporal	Has fond memories of his town, family and friends. Annual events are uplifting when he isn’t working	Summers get very hot. Make him more irritable, often increases spasms and his temper gets harder to control. Annual events are irritating and raining when he has to work.
	Virtual	Able to watch Red Sox highlights on T.V. when he is unable to watch games. Brings back fond memories of childhood and helps him relax.	Forgets to check cellphone which upsets/ worries his wife
	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)	Main concern is his family. Important he is still able to support them. Looking to find ways to adapt in order to maintain independence for as long as possible. Interested in techniques to manage outbursts and adaptive equipment for physical symptoms

I felt this book was a great way to see Huntington’s Disease (HD) as an OT. It allowed the reader to see what the progression of the disease is like and the repercussions it has on a family, not just the person diagnosed with HD. We were able to know Joe’s interests and values, and how HD changed things for him. I also like how it switched to his daughter, Katie’s, perspective to get a view from the family members. What stuck with me most was the conversation Katie had with the therapist when she was going through the process to get the HD test. I always thought the scary part was finding out you have the disease. I never thought about the guilt that would come with not being HD positive. Seeing your parent or sibling show signs of a death sentence of a disease, while you’re free to live any life you want, can’t be easy. Overall, not only did I enjoy reading this book, it helped me understand what to be aware of when working with a client. They are a person. They have a life outside of therapy, and we need to do our best to figure out how to help them live it to the best extent possible.