Joe O'Brien

Joe O'Brien. Birthdate unknown. 4/22/18

Occupational Profile

	Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	The client has recently been diagnosed with Huntington’s Disease and is seeking OT services to try and maintain the ability to perform his activities of daily living. He wishes to be able to walk his dog, Yaz, attend yoga classes that his daughter teaches, and hold his newborn grandson.
	Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)	Due to the chorea part of Huntington's, Joe is unable to currently hold his grandson because he is worried he might injure him accidentally. The chorea also prevents his wife from getting close to him in fear that she might be hit from an involuntary movement. The disease has also caused him to leave his job as a police officer, because he is no longer fit to perform the tasks. He is successful in eating Sunday dinners with his whole family and sleeping.
	Personal interests and values (p. S7)	Joe enjoys walking his dog, getting drinks with his friends Tommy and Donny, and watching Red Sox games. He values time spent with his family and his job as a police officer.
	The client’s occupational history/life experiences	The client is born and raised in Charlestown, MA right outside of Boston. He is married to Rosie and has four children, JJ, Patrick, Meghan, and Katie. JJ is married to Colleen and they just had a baby named Joey. He has been a police officer for twenty four years, and just had to retire due to the onset and worsening of this disease.
	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: father, grandfather, husband, police officer, friend.  Routines: Joe wakes up, showers, gets dressed, eats breakfast, and then would spend his day working as a police officer. Now that he no longer can, he goes to yoga classes taught by Katie, goes to physical therapy to try and strengthen his body, drinks a beer or two with friends, and sits on the couch watching the Red Sox.  Habits: his chorea has become an involuntary habit.
	Aspects of the client’s environments or contexts, as viewed by the client (p. S28)	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
	Physical	He lives in a small town that easy to walk around in.	His chorea makes a simple task extremely difficult due to the extra and involuntary movement.
	Social	He has a supportive family that assist him with anything he needs.	He desires to be more independent and not have to lean on his family so often.
	Cultural	Joe's wife is extremely religious and attends church often to pray for him.	Before this disease, Joe rarely participated in any religion-related activities.
	Personal	He is determined to stay alert for as long as he can in order to spend as much time with his children as possible.	The chorea is extremely disruptive and has caused him to lose weight fast due to the constant moving.
	Temporal	He is still so young, so before the onset he was fit and able to perform any task needed.	Huntington's disease has a timeline of progression, getting worse until they can no longer care for themselves at all.
	Virtual	New advances in technology will help Joe communicate and move when these things become too difficult for him.	Technology cannot stop the progression of the disease.
	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 would like to continue walking his dog, attending yoga classes with his daughter Katie, and hold his newborn grandson without the fear of hurting anyone.

I thoroughly enjoyed reading Inside the O'Briens. I thought it was a great way to learn more about Huntington's disease, but really see how the entire disease progresses and affects the family and friends of the individual. One part I did not like, however, was the ending. I would have loved to find out if Katie, Patrick, or Joey have the gene or not. I thought it was a sweet ending showing how everyone is supportive and this disease has not changed how tight knit they are. If anything, it has brought them all closer. I liked how everyone was there for Katie and she had come to terms with wanting to know, but I personally want to know! The weather this past week has been so nice I have found myself reading the book laying outside by the pool. While it was an assignment for class, I loved being able to relax and enjoy reading, something I have not been able to do since school started. It definitely reminded me to start taking more time to enjoy little things in the midst of a crazy school week. 

Neuro Note: Parkinson's

For this Neuro Note, I watched the Ted Talk titled Simple Hacks for Life With Parkinson's, presented by Mileha Soneji. This woman was raised in a large family, where they always looked forward to family events. She explains that one of her uncles was always the center of attention and life of the party, but that all changed when he was diagnosed with Parkinson’s Disease. He started hiding from the spotlight so that no one would give him the pitiful look that he so dreaded. Mileha hated seeing someone who was once so lively suffer like this, so she took it upon herself to try and help him perform some simple tasks easier. He had stopped drinking coffee and tea in public due to the tremors, because he could not perform this action without spilling on himself. In order to help this, she designed a cup that has “splash guards” all around the small opening so that it would not allow any liquid to come out of the cup. This allowed him to drink and not spill due to his tremors.

Another idea she talked about was his difficulty with walking. He could hardly move around on the flat floor, so she worried about how he could possibly get up and down stairs. He showed her just how he does it, and he did not hesitate for even a step. He was able to go up and down the stairs without tripping, shaking, or missing a step. The continual movement helps him stay focused and allow him to perform the action easier. Mileha had the idea to simulate this action on the flat surface to try and help her uncle with walking. She put a print of stairs on the floor and had him walk over it. Although it was still flat, it gave him something to focus on and he was able to walk smoothly over the printed stairs. Once he got to the end, he froze once again and had difficulty walking.

I chose this video because a classmate watched it and raved about how amazing of a video it is. I took her word for it and decided to watch it as well, and it definitely did not disappoint. We have not study Parkinson’s yet and I have very little prior knowledge to the disease, but I have still seen a few patients with it and have an idea of what it looks like. The cup is an idea that I may have not thought of, but it did not surprise me that it would be a solution for drinking. The stairs, however, completely shocked me. Mileha played a video of her uncle getting ready for the stairs, shaking and moving slowly, and then once he was there, he just sped down them so easily. You could hear how shocked the crowd was when he began this motion, and I was no different. I also am very surprised how much faster he could walk when just a picture of stairs was on the floor. This is such a simple, and cheap, way to help someone with Parkinson’s move easier. It is so important for people, like Mileha, to keep trying different remedies and ideas to benefit those suffering and give them easier ways to perform their tasks.  I would absolutely recommend this video to my classmates to watch for a neuro note, or even just to learn more about Parkinson’s. I look forward to learning more about the disease and how this stairway idea can be applied to more aspects of life.

Soneji, M. (n.d.). Retrieved April 19, 2018, from https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s