Aim Several factors can affect antipsychotic prescriptions, among which, caregivers. However, whether being assisted by a care worker might increase the rate of antipsychotic prescriptions at discharge from acute care hospital has not been previously investigated. We aimed to investigate whether being assisted by a care worker is associated with increased use of antipsychotics among older patients discharged from acute care hospitals. Methods The present series consisted of 928 patients not taking antipsychotics at admission in seven acute care wards of geriatric medicine in Italy (mean age 80.8 ± 7.2 years, 54.9% women). The outcome of the study was defined as receiving an antipsychotic prescription at discharge. Patients were grouped according to their living conditions as follows: (i) living alone; (ii) living only with care worker; (iii) living with care worker and family members; and (iv) living only with family members. The association between study variables and antipsychotic prescription at discharge was investigated by logistic regression analysis. Results After adjusting for potential confounders, being assisted by care workers was significantly associated with the outcome (OR 2.64, 95% CI 1.21–5.75). Diagnosis of dementia (OR 2.73, 95% CI 1.65–4.51), instrumental activities of daily living limitations (OR 1.12, 95% CI 1.05–1.21) and delirium during stay (OR 3.87, 95% CI 2.01–7.47) also qualified as independent correlates of antipsychotic prescription at discharge. Conclusions Being assisted by care workers could increase the likelihood of receiving antipsychotics at discharge from acute care hospitals. Geriatr Gerontol Int 2016; ••: ••–••.