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No / Previous studies have found high levels of undetected psychological distress and unaddressed need among care home residents. The aim of this study was to investigate the usability and usefulness of the Distress Thermometer for the Elderly (DTE; modified from a measure used in cancer care) in the identification of distress and need with older people in care homes. Method: This was a single group, cross-sectional study. Staff in 12 nursing homes and one care home in England completed the DTE and a measure of depression with their older residents (n = 66). Quantitative methods were employed to investigate the relationship between the Distress Thermometer rating, depression scores and problems or needs selected on the DTE. Results: The DTE was found to be feasible for completion by residents with assistance from staff. The level of distress on the DTE was significantly related to depression, number of problems and practical–physical problems. Each of 50 problems in the checklist was checked by at least one of the respondents. More problem items and physical–practical problems were selected by individuals who reached clinical levels of depression. Conclusions: In this preliminary study, results indicate promising potential for the use of the DTE as a simple screening tool for distress, as well as to enable residents to record their perceived needs as part of care-planning and a broader person-centred approach.

In a preceding paper [9] we reported on some experience with a new version of the well known Gröbner algorithm with factorization and constraint inequalities. Here we discuss, how this approach may be refined to produce triangular systems in the sense of [12] and [13]. Such a refinement guarantees, different to the usual Gröbner factorizer, to produce a quasi prime decomposition, i.e. the resulting components are at least pure dimensional radical ideals. As in [9] our method weakens the usual restriction to lexicographic term orders. Triangular systems are a very helpful tool between factorization at a heuristical level and full decomposition into prime components. Our approach grew up from a consequent interpretation of the algorithmic ideas in [5] as a delayed quotient computation in favour of early use of (multivariate) factorization. It is implemented in version 2.2 of the REDUCE package CALI [8].