This book really showed me what a harsh disease HD is and how it could very easily tear a family apart. I had also read a blog that told the true story of a twenty-year-old girl, Allison, who is diagnosed with juvenile HD. Her story was quite different from that of the fictional O'Briens, as her mother had already died of HD and she lived solely with her father, who was her primary caregiver. While reading about Allison taught me a lot about how HD can progress all the way through death, at least in its juvenile form, the story of the O'Briens taught me more in-depth about the beginning of HD and the grieving process a family must go through when they are not expecting this diagnosis. Joe finally knowing what his mother really died of and dealing with this was so sad to me, as he feels the shame of previously thinking she had drank herself to death and finally realizing that she wasn't the monster that she came across as, but actually a loving mother who was battling a monster inside of her.
I think reading Inside the O'Briens could help me in the future if I ever have clients with HD. It shows a much more personal side of the illness, instead of just the harsh facts presented in textbooks that do not talk about what a person and their family are going through mentally, along with the physical disability that HD causes. While I will never really know what they are going through, I may now be able to empathize more than if I had only learned about HD through textbooks or what I'd found online.
References:
Genova, L. (2015). Inside the O'Briens. New York, NY: Gallery Books.
Occupational Profile
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Reason the client is
seeking OT services and concerns related to engagement in occupations (may
include the client’s general health status)
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Client has been having trouble being still and walking
recently. He has also started having random outbursts of anger. These
problems are due to his recent diagnosis with Huntington’s disease (HD).
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Occupations in which the
client is successful and barriers or potential barriers to his/her success in
those occupations (p. S5)
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Client takes pride in being a Boston police officer. He is
also a husband, father, and dog owner. His random movements (chorea) and
difficulty walking have been a barrier to his job as a police officer, and
his anger is harming his relationships with his family.
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Personal interests and
values (p. S7)
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Client values being a loving and supportive father and
husband. He enjoys baseball, particularly the Red Sox. He also enjoys hanging
out with his friends outside of work.
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The client’s occupational history/life
experiences
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Client lives on the first floor of a three-story home with
his wife and their four grown children. Client has previous knee injury,
which is what he was attributing his problems walking to. His job has always
had a lot of influence on his personal life and overall personality. At his
job, client must chase after suspects, fire his gun when necessary, and fill
out reports on arrests or other situations.
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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)
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Some roles client is in are father, husband, and police
officer. On a typical day, client wakes up, gets ready for work, drives to
work, does whatever is necessary for work that day, goes home, has dinner,
watches the news, gets ready for bed, and goes to bed. Client has had
difficulties remembering what happened when he is writing reports for work.
He often gets angry at people for no reason, which has been upsetting his
family. Client brings the family dog for walks a few times a week, which can
be harmful if he falls because he goes by himself. Client also drinks
regularly, which can contribute to his uncontrollable mood swings and lack of
coordination.
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Aspects of the client’s environments or contexts, as
viewed by the client (p. S28)
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Supports to
Occupational Engagement:
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Barriers to
Occupational Engagement:
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Physical
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Client lives on first floor and does not have to climb
stairs.
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Home is somewhat small and client has accidentally hurt
others in the family if they are in close proximity to him due to the chorea.
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Social
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Family is very supportive.
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People at work do not know client has HD, so he has been
getting in trouble due to the symptoms.
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Cultural
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The culture of client’s close friends and family encourage
him to go to the doctor and do what he can to help his HD.
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Culture does not understand differences, and people often
stare at client due to his uncontrollable movements.
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Personal
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Client’s personality is one that is strong and he wants to
fight the disease.
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Client is embarrassed to admit to the public that he has
something wrong with him.
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Temporal
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Client has been married for about 25 years, so the
stability of this long-term relationship is comforting.
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Client still has more than ten years left in his job until
he can retire.
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Virtual
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Cell phones enable client to be in contact with friends at
work so he can check on them and vice versa.
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Client obsessively texts wife for no reason.
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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)
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Client would like to keep his anger outbursts under
control. He would also like to work on walking, strength, and balance to
maintain these things as long as possible.
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