A typical pretext for prescribing these drugs is that the patient is agitated or upset - assertiveness framed as aggression. In other words, if an old person complains about the quality of care, the easiest way to fix the problem is to slip some olanzapine into the cocoa. If there is any psychosis here, it is in the system and not in the individual.
Drugs may be justified if they provide some therapeutic benefit for the patient, but not if their purpose is merely to compensate for the inadequate care offered to old people. The BBC has found cases where the patient's life appears to have been significantly degraded or shortened by these drugs, simply to make things easier for the carers. The use of these drugs for this purpose is deeply unethical.
Meanwhile, there is a much better and cheaper remedy for agitation among demented patients: drinking more water.
- BBC News: How care home keeps elderly healthy