An Interdisciplinary Approach to Successful Aging

Nardi Steverink (Courtesy of Nardi Steverink)

Nardi Steverink was in her 20s when she became interested in researching how to help people grow old. She was an undergraduate studying psychology at the University of Utrecht in the Netherlands, her native country. In the increase in the elderly population she saw an opportunity to do good for society, along with promising job prospects.

"The old people who are doing very well inspire me to look at the possibility to help people who are not doing as well." -- Nardi Steverink

In the years since, Steverink has turned that interest into a research career in "successful aging," which she defines as "how people age with a high level of well-being." She looks at why "some people are doing very well up to very old age while others are doing much less well, and how you can explain that from social and psychological factors," says Steverink, a senior researcher in the social and behavioral sciences with appointments at the University of Groningen and the University Medical Center Groningen in the Netherlands.

Steverink's research spans the theoretical and practical: She has developed a theory of psychological well-being in older people, she studies their capacity to manage their own well-being, and she creates courses to teach elderly people self-management skills. "Her work is a textbook example for how to do rigorous social-scientific research that can be translated for the benefit of society," Rafael Wittek, the chair of both the Interuniversity Center for Social Science Theory and Methodology (ICS) and the Department of Sociology at the University of Groningen, writes in an e-mail to Science Careers.

An interdisciplinary background

Exposure to different disciplines has been an important factor in the evolution of Steverink's research. "I had a lot of opportunities to work with others, and speak with others, during my career," she says. "It opens up your mind and it challenges you to integrate insights" from other fields.

Steverink initially pursued a music career, but "during my music studies I discovered that I wanted not to be a music teacher but to do something with people and behavior," she says. She went on to obtain her 4-year degree in psychology, interviewing elderly people in their homes for her final-year research project to assess their preferences for different kinds of nursing homes.

But aging-related jobs were few when she graduated in 1987, so she took a 2-year research assistant position in the former Department of Medical Psychology at the University of Utrecht. There, she studied the coping strategies of cancer patients. The research primed her to the concepts of well-being and self-management, she says.

Focus on Aging Research

Researchers in many different disciplines are looking at how to make our aging population stay healthy for longer. Throughout the month of May, Science Careers will publish profiles of scientists studying healthy aging from the perspective of genetics, sociology and psychology, engineering, and neurology.

Steverink went on to do a Ph.D. in social and behavioral sciences at ICS. During her undergraduate research project, she "found [it] sometimes very difficult to understand why people wanted to give up their independence," she says. So she made that the subject of her graduate research.

While health problems are often the rationale for sending frail, elderly people to nursing homes, during her Ph.D. she found that "it is only when people also have a high level of loneliness together with the health problem that they want to give up their independence," she says. As their personal, social, and practical resources diminish, people are able to compensate for a lot of losses; for example, they may offset declining social participation with love and affection of one who is close, she says. But there is a "critical phase when people lose the possibility for compensation" and see the nursing home as a last resort to maintaining their well-being.

Steverink developed this finding into a theory of well-being among older people. She defined psychological well-being as the fulfillment of essential basic physical and social needs. While love and affection is important, she found through interviews and questionnaires that older people "also have a need for feeling useful and being appreciated for [being] special" within broader social groups, she says. She developed a scale to measure well-being in terms of five dimensions: physical comfort, physical and intellectual stimulation, affection, confirmation from others that you're doing right or useful things, and status.

Applying the theory

Toward the end of her Ph.D., Steverink took a 2-year position working on a large longitudinal aging study run by the University of Groningen's Northern Center for Healthcare Research, which also gave her a bigger data set for her Ph.D. research. Upon graduating in 1996, she did a 4-year postdoc in the Department of Psychogerontology at the Catholic University of Nijmegen (now the Radboud University of Nijmegen).

While there, she began to incorporate self-management into her well-being theory. Self-management is about knowing "what makes you happy or feeling good, and then knowing how to think and behave in a way that you can arrive at positive outcomes for yourself," she explains. She identified a set of skills that makes older people better able to manage their own well-being, such as the ability to adopt a positive frame of mind, take initiative, and maintain a diverse supply of well-being.

After her postdoc, Steverink returned to Groningen to be with her partner (now husband) and joined the Department of Geriatrics (now the University Center for Geriatric Medicine) at the Groningen University Hospital (now University Medical Center Groningen). The clinical focus of her new institute allowed her to see "with my own eyes that you have to look at older people in a holistic way," she says. While it's common in the medical field to look at older patients in terms of a specific disease, "it doesn't make so much sense ... because most have more than one disease, and a lot of the problems also have to do with the social situation."

Steverink won a grant from the Netherlands Organisation for Health Research and Development to develop and implement successful aging interventions as a follow-up to the longitudinal aging study she contributed to as a Ph.D. student. In collaboration with social and health care professionals, she designed and tested novel training courses for older people to improve their self-management skills.

Courtesy of Nardi Steverink
Nardi Steverink gives a workshop to social care professionals on how to train older people to improve their self-management skills.

Over the period of 6 weeks, "we teach people to look at their own situation in terms of the five dimensions of well-being," Steverink says. "Then, we take them by the hand and lead them through [learning] the abilities." The courses, during which Steverink monitors participants' progress, also inform her research with new data and insights. "The old people who are doing very well inspire me to look at the possibility to help people who are not doing as well," she says.

Steverink obtained her current, permanent position in 2004, though she changed departments -- moving to the Department of Health Sciences -- in 2007. The same year, she was given a part-time associate professorship back in the Department of Sociology at the University of Groningen to teach master's degree courses. Her position was extended last year so she could continue honing her research on self-management and well-being.

Looking to the future

Aging-related research programs are still run on an ad hoc basis and funding remains difficult to get, but since she entered the field, "there has been much more attention from the government [and] from the research organizations in the Netherlands for aging research," she says. The field is here to stay, Steverink believes. "It's a very new phenomenon that there are so many older people already, but also in the years to come the percentage of old people in our society will be really huge."

When considering how to deal with the challenges ahead, most "people think right away in terms of health care centers and programs," she says. But as more and more people remain healthy as they advance in years, "we also have to think about ... how we can keep them [not only] healthy for as long as possible but also happy" so that they can continue to live independently.

Elisabeth Pain is Contributing Editor for Europe.

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