Tideswell at UCSF focuses on one of the greatest needs in healthcare today – improving the quality of care for older adults with chronic conditions and functional limitations living in our communities.  This population accounts for a large portion of healthcare costs in the U.S.  By applying and adapting the most compelling research, care models, and training to the real needs of older adults in our communities, our work greatly improves the quality of care while significantly relieving the burden on families, communities, and the economy.

Historically, scientific research has not focused on the needs and concerns of older adults or their caregivers. Older adults are routinely excluded from large research trials of medicines and clinical innovations, and, as a consequence, evidenced based approaches to care for older patients  are not often put into practice.

What We Do:
We are committed to improving care for aging adults living in our communities by:
– Developing, testing and disseminating best practices for providing optimal patient care
– Attracting and training caregivers and future leaders in the field
– Partnering with others focused on elder care

Why We Do It:
Current standards and accessibility of caring for the aging must be transformed so that:
– Every person has the knowledge and skills to treat older adults with the dignity they deserve
– Older adults receive the optimal care that they need now and can continue to live fulfilling lives in the community

Why the name Tideswell? Tideswell comes from combining two separate words: Tides: refers to the rising tides of the aging population, and Well: supporting these rising tides skillfully or proficiently. The name conveys the awareness that addressing the rising tide of the aging population requires creative, collaborative, and evidence-based care.

Our Team


Christine Ritchie, MD, MSPH, Director of Tideswell

Dr. Ritchie is the Harris Fishbon Distinguished Professor in Clinical Translational Research and Aging at UCSF. She is a board certified geriatrician and palliative care physician who has developed and evaluated a number of comprehensive clinical programs for seriously ill older adults, including inpatient and outpatient palliative care programs, community-based complex illness programs, and home care medicine programs.

Email: Christine.Ritchie@ucsf.edu | Full Bio


Anna Chang, MD, Associate Director for Education and Leadership

Dr. Chang is a physician, a teacher, and a leader in the areas of clinical care of older adults with multiple serious illnesses, and in the education of future physicians who will care for aging Americans. She is an Associate Professor in the Division of Geriatrics at UCSF and is a board certified geriatrician and palliative care physician. Nationally, she works with geriatrics teachers in the US through the American Geriatrics Society Education Committee.

Email: Anna.Chang@ucsf.edu | Full bio


G. Michael Harper, MD, Associate Director for Clinical Care Models

Dr. Harper is a geriatrician and a Professor in the Department of Medicine at UCSF. For two decades he has cared for older adults across the continuum of geriatrics care from housecalls to hospitals and from nursing homes to continuing care retirement communities. Dr. Harper’s interests are in the development, implementation and evaluation of innovative models of care that meet the diverse needs of community-dwelling older adults with multiple illnesses and functional limitations.

Email: Michael.Harper3@va.gov | Full bio


Brie Williams, MD, MS, Associate Director of Discovery

Dr. Williams is an Associate Professor of Medicine in the UCSF Division of Geriatrics and Medical Director of the San Francisco VA Geriatrics Clinic. She directs Tideswell’s community training initiatives that design and implement targeted educational programs to address the preparedness of all professionals to provide optimal care and services to our aging population. As a Clinician-Researcher, she collaborates with professionals from the criminal justice, correctional health and legal fields to apply geriatrics and palliative medicine paradigms to transform the care of older adults in the criminal justice system.

Email: Brie.Williams@ucsf.edu | Full bio


Suzanne Kawahara, MBA, Deputy Director

As Deputy Director of Tideswell, Ms. Kawahara oversees its managerial, financial and operational functions. She also focuses on Tideswell’s initiatives to educate the community about aging. Tideswell has developed several partnerships with community groups including the SF Institute on Aging, Aging 2.0, the Consumer’s Union, the Jewish Community Center and the San Francisco Department of Aging and Adult Services. Ms. Kawahara brings expertise in leadership development and is involved with developing and implementing the strategic initiatives for the UCSF Department of Medicine.

Email: Suzanne.Kawahara@ucsf.edu | Full bio


Sarah Garrigues, Senior Program Manager

Ms. Garrigues ensures that Tideswell’s healthcare models are continually developed and rigorously evaluated in order to provide the best care possible and improve the quality of life for patients and their caregivers. She oversees Tideswell’s efforts to develop a robust database infrastructure to facilitate the tracking of health care quality and analysis of innovative clinical care programs for older adults who receive care in their home. Ms. Garrigues’ interest in healthcare for older adults grew out of her interactions working with seriously ill patients in a palliative care research setting.

Email: Sarah.Garrigues@ucsf.edu | Full bio


Deb Barnes, PhD, MPH, Senior Investigator

Dr. Barnes is an Epidemiologist and Senior Investigator at UCSF, and her primary role is to provide guidance on issues related to study design, analysis and evaluation of the educational, clinical, and research projects supported by Tideswell. She is passionate about working to help every older adult live the fullest life possible, in sickness and in health, and her personal research focuses on identifying risk factors for cognitive impairment and dementia and developing effective strategies to delay onset, slow progression, and maximize quality of life.

Email: Deborah.Barnes@ucsf.edu | Full bio