So here’s another TP story. This one I wrote and it was published in Voices From the Plains, 2nd Edition, 2018 pp. 214-216.

Walking down the carpeted hall toward the dining room at Mountain Shadows Nursing Home in Las Cruses, NM, I saw a call light come on above the door to Room 205. I knew the resident who lived there, but she was not my client for occupational therapy. All the nursing assistants were busy getting residents to the dining room for lunch, so I thought I would stop to see what Mrs. McKinley (not her real name) wanted. Knocking on the door before I entered the room and hearing no response, I figured she was in the bathroom, so I knocked a bit louder and entered the room.

The television was on to the news station she frequently watched. “Mrs. McKinley?” I heard a “yes,” coming from the bathroom. Walking over to that door, I knocked again.

“Well, come in for heaven’s sake. I’ve been sitting here for hours,” Mrs. McKinley said. Her newly permed white hair glowed in the light coming from the bare bulb above the sink. She was sitting on the commode with one hand on the grab bar attached to the wall next to the toilet.

“Do you need help getting up?” I asked. She had been doing fine with transfers from the commode to her wheelchair when I had discharged her from occupational therapy a few weeks ago. “What seems to be the problem?”

“Oh, that nurse assistant told me she’d be right back, but that was ages ago. What I need is a new roll of toilet paper. She was going to go get me some, but she hasn’t been back. I just need to wipe and get of this dumb thing.”

“I can get some toilet paper for you and I promise to be right back.”

I turned and went to the closet where there was supposed to be toilet paper. There was none. I hurried to the store room at the back of the building and got four rolls of tissue to stock Mrs. McKinley’s closet and get a new roll to her in the bathroom. When I returned to her room, she was still in a sour mood. She took the toilet tissue, rolled some paper off into her hand, then gave the roll back to me. She cleaned herself before standing to pull up her underpants with one hand. Her other hand back on the grab bar. After adjusting her skirt, she turned to sit in her wheelchair.

“I just need to wash my hands, then I’ll be ready to go to lunch.” I moved out of the way so she could reach the sink. After she washed her hands, I handed her a towel to dry them. I stepped to the commode and began putting the toilet paper onto the holder.

“Oh, no, not that way,” Mrs. McKinley said. “Don’t you know I’m a front roller? Turn the roll around so that the paper comes off from the front of the roll.” I did as I was told. “You know,” she added, There are front rollers and back rollers in this world and it’s important for you to know the difference.”

I walked beside Mrs. McKinley as she pushed herself to the dining room. “It is very important for you to pay attention to which way the toilet tissue comes off the roll. When you are living in a place like this, it can make a big difference in a person’s day as to which way the toilet tissue comes off the roll.” She smiled at me, then rolled herself over to her table and began chatting with some friends.

The thought had never occurred to me that such a thing as to which way the toilet tissue came off the holder could be so important. As I took notice, however, clients did have a preference for which way the toilet paper came off the roll. From then on, I suggested to housekeeping staff to be on the lookout for how they put the rolls of toilet paper on in residents’ rooms. Sometimes during an occupational therapy evaluation, I would ask a new resident which way they preferred their toilet paper to come off the roll, front or back. Some had a distinct preference, others did not seem to care, or had never thought about it themselves.

At our next Medicare survey there was a comment by the survey team, that at this facility residents remarked that their toilet paper was put on the holder the way they preferred. The residents found that very beneficial to their sense of well-being.

So, the next time you put a new roll of toilet paper on the holder, watch which way you prefer. You might be a front roller and put the tissue on in a back roller fashion, not knowing you are affecting how you will feel throughout the day until you change the roll to the way your prefer. It’s good to know if you are a front roller or a back roller for your own mental health.