Occupational Profile for Joe O'Brien
Reason the client is
seeking OT services and concerns related to engagement in occupations (may
include the client’s general health status)
|
|||
Occupations in which the
client is successful and barriers or potential barriers to his/her success in
those occupations (p. S5)
|
Occupations in which client is successful:
·
Fixing things around the house
·
Supporting his wife
·
Caring for children
·
Completing paperwork
·
Driving
·
Walking
·
Carrying a gun
·
Chasing down criminals
·
Communicating with coworkers
·
Walking dog
·
Feeding dog
Joe has been able to successfully complete all of these
occupations along with his ADLs such as showering, brushing his teeth, and
dressing, his occupations of sleeping and leisure activities, and more until
now. Joe is starting to experience
some trouble with these occupations due to HD, and his ability to complete
them will further decline as his disease progresses. He is already starting to experience some
trouble with walking and concentrating on completion of tasks. Huntington’s disease will cause barriers to
all of his occupations, so all of these areas can be worked on in his OT
sessions specifically addressing his occupations that will keep him
independent longer such as walking, ADLs, working, etc.
|
||
Personal interests and
values (p. S7)
|
·
Watching baseball
·
Walking his dog
·
Spending time with his family, Sunday supper
·
Watching his daughter dance in the ballet
·
Participating in Irish traditions
·
Loving on his wife
·
Church is very important to his wife, but he
is not too involved.
|
||
The client’s occupational
history/life experiences
|
The client comes from Irish heritage and was born and
raised in Boston. Growing up his mother was diagnosed with alcoholism and had
to live in a mental institution where she died. Now Joe knows that his mother unfortunately
had Huntington’s as well and that it was not alcoholism that led to her
debilitating disabilities. Joe has a
wife, Rosie, and four children. He has
worked with the Boston Police Department for twenty years and loves his work
and his family very much. For the past
seven years Rosie has noticed some changes in him with his memory and his
irritability. Recently he has also
struggled with his balance, coordination, reflexes, mental confusion, and
abnormalities in his movements. He has
fallen down stairs, walked the wrong direction in drill training repeatedly,
and dropped glass pitchers shattering them over Sunday meals. His coworkers and Rosie were concerned about
him thinking he might be alcoholic or using drugs, so Rosie encouraged him to
see a doctor. He thought he was seeing
the doctor to just check a knee he injured, but he is referred to a movement
specialist doctor who believes he has Huntington’s. Genetic testing is done on Joe, and his
diagnosis is confirmed. This diagnosis
has caused a significant amount of family stress, and he has been referred
for OT services to help him adjust to changes that are happening in his body
and help him accomplish his occupations that are meaningful to him related to
his work, self-care, and family.
|
||
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
·
Boston Police Officer
·
Co-worker
·
Pet Owner
·
House Owner
·
Husband
Joe has performance patterns such as walking the dog,
working, caring for his family which includes Sunday meal, important Catholic
holidays, and more.
Joe’s daily life routine are at the bottom of the
document.
Patterns that will support the client’s occupational
performance are his loving, supportive family that is willing to help him adjust
to the changes his body will make.
Because of his time on the police force he is very disciplined and a
very hard worker. He will try very
hard to reach his goals in therapy that will help accomplish more of the
tasks that are meaningful to him.
Patterns that will hinder his occupational performance are his poor
interactions with health care professionals so far that diagnosed him. He is angry at the way the doctor diagnosed
him and is skeptical of health care professionals. The OT will need to develop rapport and
make sure the sessions are centered on his meaningful activities. One of the patterns in Joe that his wife
has mentioned and is a symptom of HD is anger and confusion. These patterns can be barriers to his
occupational performance as we proceed with therapy.
|
||
Aspects of the client’s environments or contexts, as
viewed by the client (p. S28)
|
Supports to
Occupational Engagement:
|
Barriers to
Occupational Engagement:
|
|
Physical
|
His whole family lives in the house with him and are
willing to make adjustments in the house to fit his needs.
|
After ten years or so Joe will likely not be able to walk
or live in his home. His balance and
coordination problems will cause him to have an increased risk of falling at
home or while he is out of the house.
|
|
Social
|
He has a very supportive family and friends who want to
help him engage in his occupations.
|
The progression of his disease might ostracize some people
in his life and his children might become bitter towards him for potentially
giving them Huntington’s as well.
|
|
Cultural
|
Most Americans have a very empathetic and supportive
attitude towards individuals with disabilities. Joe will have more services to help him
than many other people across the world.
|
Some of Joe’s coworkers believe that he has a drinking
problem and that is the reason he is struggling cognitively and physically. People might have a stigma towards him
because they do not understand Huntington’s.
|
|
Personal
|
Joe is a hard worker, and he will try to take care of
himself as best he can.
|
Joe has always been a very independent and strong-willed
individual. The progression of Huntington’s
will be very humiliating for him, and he will struggle with his
independence.
|
|
Temporal
|
Joe realizes that as a police officer he places himself in
dangerous conditions on a daily basis.
He realizes that he is blessed to have lived as long as he has despite
how awful his prognosis is.
|
The progression of Joe’s disease will decrease the time
that he has with his family and time that he can be independent in his
occupations.
|
|
Virtual
|
Technology will greatly assist Joe in helping him maintain
his independence and improve his functionality as his health declines.
|
Joe will have problems with chorea meaning that he can
easily break technology and it will be more difficult to use.
|
|
 |
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’s main concern is trying to maintain his independence
as long as he can. He wants to work at
his job as long as he can because he gains meaning and purpose from his job,
and he wants to provide for his family.
He wants to continue occupations such as walking the dog, house
chores, spending time with his children, and loving on his wife as long as he
can. One of Joe’s main goals will be
to maintain his current level of occupational performance. Another main intervention focus will be to
modify his routines and habits to incorporate adaptive equipment and
technology so that he can stay safe while participating in his occupations
and be able to complete more of his occupations despite his health
declines.
|
|
Joe’s mother was admitted to a mental institution where
she was believed to have suffered from alcoholism. Now Joe knows her debilitating condition
and death was caused by Huntington’s.
|
For the past six to seven years, Joe’s wife has noticed
some changes in his irritability, memory, and motor functioning.
|
These past few months Joe’s coworkers and wife have
noticed many changes in Joe’s motor and cognitive functioning and believe he
is maybe alcoholic or on drugs. Joe
assures his wife he is not on drugs or alcoholic and is willing to see a
doctor.
|
Joe goes to an orthopedist about his knee about four
months ago, which he believes is the source of his balance and coordination
problems, but he is referred to a neurologist.
|
Two months ago, Joe saw a neurologist, and she did many
tests on him and asks about his family history. She suspects Joe has HD and wants him to
have genetic testing done to confirm the diagnosis.
|
Joe’s genetic tests confirm that he has Huntington’s. The diagnosis is a shock for the family,
and he has been referred for OT services to help him adjust to life with
Huntington’s.
|
Performance Patterns:
6:00- wakes up, eats breakfast, takes dog on walk, gets
ready for work
7:30- goes to work
5:00- Gets off work and drives home.
6:00- Eats supper with his family
7:00- Watches a baseball game or goes on a walk with the
dogs
9:00 prepares for bed
10:00- goes to sleep
|
Comments
Post a Comment