Elderly care should be better regulated, says nursing leader It also said health workers should not address patients as "dear" or "chuck" without permission. "The vast majority of care for older people in hospitals is provided nowadays by health care assistants under the supervision of nurses," Dr Carter added. In most cases, they don't have adequate training. They don't have the education and what we have is an unskilled, unregulated workforce however well intended. Calling for greater regulation of those caring for elderly patients, Dr Carter said: "I don't believe the pendulum has swung too far. I still believe the vast majority of nurses do provide good, dignified professional care. We have had huge changes and as a society, we have not adjusted to the fact we have more and more people living longer but they are not necessarily living longer healthier. What we now know is the majority of people in our hospitals are older people. The health service has not changed to adjust to it. Today's report from a commission including Age UK, the NHS Confederation and the Local Government Association said undignified care was "rooted in the discrimination" of older people. The report calls for a "major cultural shift" covering training and regulation of care workers and medical staff.