Occupational therapist Robin Cox attaches a tray to Ceylene L. McGinnis' walker so she can transport food from the kitchen. "Modifying and adapting the environment to be the best it can be is a lot of what I do, and since many patients can't afford expensive assistive devices, we improvise," Cox said.

The trunk of Robin Cox's car is filled with duct tape, pulleys, exercise bands, sticking putty, old telephone books and a recipe for homemade play dough. She never knows what she will need in her job as a registered and licensed occupational therapist with Visiting Nurse Health System, an Atlanta-based nonprofit home care provider.

So she comes prepared. Many OTs work in hospitals or rehab clinics with a gym and equipment at hand.

"Part of the challenge of working in the home environment is that you have to rely on yourself and what you can do for the patient with whatever is available," Cox said.

In college, people noticed that Cox liked arts and crafts and enjoyed working with people. "I was creative and I never met a stranger. Someone suggested that that combination would make a good OT," she said.

It proved to be good advice. After 34 years, Cox has never looked back.

Although most newly graduated nurses start out working in hospitals or health care facilities, Cox began her career in the home health arena in Portland, Maine. The experience taught Cox to rely on herself and to seek out community resources to help her patients. "It broadened me inside," she said. Cox went on to work at a rehab center, in acute care, for a spinal cord injury program and at a children's hospital in Birmingham, before returning to home health 12 years ago.

"It's my favorite," she said of her OT career. "We assess and plan rehabilitation activities for every kind of patient, so I call myself a generalist."

She performs hand therapy on a woman with an ischemic hand and poor blood flow. She helps elderly patients with fractured hips or progressive neuromuscular diseases.

She teaches a young man who's had a stroke how to safely get in and out of the shower and organize his many medications. She helped him rearrange his bedroom so that he can get to the bathroom and living room easier.

"Modifying and adapting the environment to be the best it can be is a lot of what I do, and since many patients can't afford expensive assistive devices, we improvise," Cox said.

Sometimes she's fortunate to receive free equipment from Friends of the Disabled, a nonprofit supply center in Stone Mountain. Cox has a knack for creating homemade devices. A thrift store tray attached to a walker with duct tape makes it easier for a patient to carry things around the house. Colored duct tape on the microwave buttons helps someone with poor vision. A kitchen sink works as an exercise bar; soup cans as weights for exercises.

"It's fun and totally satisfying every day and a little bit of magical thinking goes a long way," she said.