Meet our GERI Researchers | Dr Grace Sum Chi-En

Dr Grace Sum Chi-En is a Research Fellow at GERI. She obtained her PhD in Public Health from the Saw Swee Hock School of Public Health, National University of Singapore, under the President’s Graduate Fellowship. Her research interests include implementation research and programme evaluation in areas related to implementing integrated healthcare services to prevent functional decline and maintain intrinsic capacity in older adults. She enjoys writing academic articles and conducting advanced quantitative methods and systematic reviews.

We chat with Dr Sum on her journey to health services research for older adults, leaving her comfort zone to grow her research repertoire and why intrinsic capacity matters.

How did you first get into research and subsequently, the study of ageing issues? 

When I was a student in veterinary school, I had opportunities to contribute to several research projects. I learnt that I preferred conducting research, compared to performing surgeries and diagnosing individual patients. A major part of my training was on geriatric medicine, as most pet owners need to care for animals in their old age until end of life. My interest in public health was further fostered during the early part of my career when I contributed to multi-organisation projects to develop work plans and policies, as a public servant in an agency under the Ministry of National Development.

On a personal level, I know first-hand the challenges of growing old as I grew up with great-grandparents and grandparents. My PhD thesis was on the health and social burden on older people with multiple chronic conditions. I joined GERI to continue my journey on contributing to the practices and policies that enable healthy ageing in Singapore.  

What are you currently working on? 

I am working towards the dissemination of research findings on the healthcare use and cost from an evaluation project on a frailty management programme for older people in the community. In addition, I am in a couple of projects that use qualitative research to understand the hindrances of implementing healthcare programmes for older people with frailty or declines in intrinsic capacity, to refine implementation strategies prior to the initiatives being rolled out.

Across projects, an important part of my work at GERI involves collaborations with people across research institutes and healthcare clusters. Finally, my ongoing job is to keep learning, including soft skills like negotiation techniques, advanced statistical methods, qualitative research and health policy research. 

Your review​ on the World Health Organization (WHO) Integrated Care for Older People (ICOPE) framework highlights the importance of screening for intrinsic capacity to achieve healthy ageing. How do you think individuals and communities can be more empowered in keeping track of their own intrinsic capacity?

As you may know, Singapore is on track to attain "super-aged" status by 2026, defined as having 21 per cent or more of the population being 65 years and older. I think we need to have a mindset of preventing and preserving our health and well-being, instead of seeking treatment only when problems arise. This is to prevent overburdening our hospitals and long-term care facilities. I am working on projects related to intrinsic capacity, a concept introduced by the WHO in 2015. Components of intrinsic capacity include cognitive function, mobility, psychological well-being, vitality, sight and hearing. Regular screening for declines in these components is a step in the right direction towards detecting problems early so that people can age at home and within their communities.

I think that empowerment to monitor one's intrinsic capacity could be from awareness of the concept itself, and access to resources to screen for declines. A fun fact is that you can download the WHO ICOPE mobile application to do a series of self-administered tests to find out about your intrinsic capacity. This brings me to the point that digital tools can play a vital role in enabling people to monitor their health and manage matters like medical appointments and medications. A proportion of older individuals will need support from family, friends, or healthcare workers on the use of technology. 

Why do you think your work at GERI is important and what kind of impact do you ultimately hope to create? 

I believe the work is meaningful because we transform research evidence into real actionable changes in healthcare policies and practices in primary care, hospitals and the community. I hope to play some part in contributing towards improving healthcare services for the ageing population and enabling Singaporeans to grow old while maintaining their quality of life. 

What do you like about working at GERI and what have been some memorable experiences so far? 

I am extremely grateful for the mentorship and opportunities at GERI. I love the diversity of my work, from evidence synthesis, programme evaluation and implementation research, to research communications, engaging collaborators and stakeholders, and publishing academic papers and conference proceedings. Memorable experiences include using advanced quantitative methods to analyse large national datasets, leaving my comfort zone to do qualitative research and presenting at an international conference overseas. Most of all, I’m encouraged by the collaborative environment at GERI. 

What are some personal interests and activities that you do in your spare time that help protect against functional decline? 

I have a hamster and two gerbils that were adopted and are now geriatric. Cleaning their large cages, playing with them, and administering medications are tiring and can feel like a physical workout! I enjoy taking strolls, visiting museums and exhibitions, cafe hopping, and watching documentaries and psychological thriller movies with my husband.