A report from Healthcare Improvement Scotland expressed concerns about disrespectful language and poor documentation after an unannounced visit by inspectors to St John's Hospital in Livingston, West Lothian.
The team identified areas of strength in treatment of elderly patients but cited 15 areas where improvements were required, saying staff's awareness and knowledge of delirium was poor. It was noted that ward buzzers were heard ringing unanswered for lengthy periods.
One patient with a known history of Alzheimer's had "happily confused" written in their patient health record.
The report said: "This is not respectful language to use when describing a patient with dementia.
"There was no plan of care for their dementia."
Regional inspector Ian Smith said that, while some wards at St John's had dementia champions, their role was unclear and it was "not evident" how they were improving dementia care.
The report added that NHS Lothian must ensure improvements to the ward and hospital environment were carried out to make it more suitable for people with dementia and cognitive impairment.
Sarah Ballard-Smith, nurse director at NHS Lothian, said yesterday: "It is pleasing to note 95% of patients interviewed felt the care they received was of a good standard.
"The inspectorate found we are performing well in relation to the care provided to older people, with warm, caring and meaningful interactions between staff and patients.
"Other areas of good practice include that our staff were seen to be treating patients with dignity and that the care we provide is compassionate and respectful. There were some areas which the inspectors felt could be improved upon and we have already addressed each of these issues."