This paper uses a patient example to demonstrate the pervasive influence of culture on an individual’s values, goals, interests, roles, habits, and performance. Culture is a filter through which patients determine the direction and degree of their involvement in self-care, work, and leisure activities. Every occupational therapist intervention depends on an exchange of values. The constraints of home care practice accentuate the therapist’s need to create a therapeutic environment that is understood and valued immediately. As a guest in the patient’s home, the home care occupational therapist must quickly incorporate the patient’s needs into the therapeutic program.