Background: Leaders play an essential role in the health care of older adults. The leadership role has changed over the years because of new demands in providing care for older adults with multiple chronic conditions, as well as a lack of resources. Aim: The aim of this study was to describe formal leaders’ views over time on their leadership and the competence among staff in care of older adults.Method: Individual interviews and focus group discussions with leaders in care of older adults were conducted with a total of 46 formal leaders in 2000 (n=20) and 2011 (n=26). The analysis took a qualitative approach, using interpretative description. Results: The leaders’ descriptions of leadership encompassed two different views on leadership over time, from “I as a leader” to “We together”. The leaders interviewed in 2011 saw practical wisdom (phronesis) as a central aspect of staff competence. Throughout the interviews, a greater focus on personal characteristics was seen over time. Conclusions: Differences over time in views of the leaders’ role and staff competence, especially the increased focus on personal characteristics, may have an impact on the health care provided to older adults. This is particularly true if formal education is not prioritized. Strategies within organizations and continuing development and education must take these changes into consideration