I strongly believe there is a difference. I was in LTC before my current role and have worked under those I consider to be leaders and those I consider to be managers. When working under a manager patient centred care was not the focus. The focus was on not having falls, incidents, or admissions to hospital as only the statistics mattered. Under leaders, we were able to negotiate risk and advocate for resident directed care. We were able to successfully reduce and often eliminate antipsychotic use by focusing on the resident’s needs and non-pharmacologic approaches to care. I can recall numerous residents who moved in so sedated. When looking for the root cause of why antipsychotics were initiated it was often due to ‘wandering’ or ‘aggression’ but when you would look deeper that wandering could have been due to being in hospital and aggression from now being restrained (we were able to eliminate all successfully). Or a gentleman who was about 5 days post hip surgery when he came to us – the site was infected and looked to be quite sore. He was on no pain medications but significant increases to antipsychotics had occurred – we took care of the pain and infection and these medications were no longer needed. With the support of a leader we were able to increase quality of life for the residents and their loved ones rather than fearing the outcomes and not acting.