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On New Year's Day, it's Morning Edition from NPR News. Good morning, I'm Steve Inskeep. Today in "Your Health," helping older people give up their cars. Mile for mile they have the highest driving fatality rate of any group other than new teenage drivers. But getting older people to stop driving takes more than just telling them to give up the car keys. Many people need their cars because of where they live. NPR's Joseph Shapiro has the story of one woman who's come up with an alternative.

JOSEPH SHAPIRO: Through the work she does, Katherine Freund has watched what happens when older people can no longer drive safely. Often they do something surprising when it's time to give up their car.

Ms. KATHERINE FREUND (Founder, Independent Transportation Network): People generally leave their vehicles in their driveway, I would say - this is an estimate - six months after they can't drive anymore. Sometimes they get in the seat behind the wheel and visit it.

SHAPIRO: Not drive it. Just...

Ms. FREUND: Visit it. You know, people do that. That's common.

SHAPIRO: That's because, especially for older people, cars are not just useful, they're pretty powerful symbols.

Ms. FREUND: Cars are just machines, but they represent mobility and independence and freedom. And long after people can safely drive them anywhere at all, they still have that symbolic meaning of independence and freedom.

SHAPIRO: So the car sits in the driveway unused. But after a while the car insurance comes due or it's time for the car inspection.

Ms. FREUND: That's when they get given to the grandchildren or sold to the neighbors for a song. And that was one of the reasons that I began thinking there must be a better thing to do with this car.

SHAPIRO: The better thing, Katherine Freund figured out, was how to let people give that car away and then use its value to pay for a car service. The money, it might be hundreds or even thousands of dollars, goes into an account that pays for someone to come pick them up and drive them where they need to go. Freund started that not-for-profit car service over 13 years ago. It's called the Independent Transportation Network. ITN now exists or is starting up in 12 communities around the country after Freund made it work in her hometown of Portland, Maine.

(Soundbite of knocking)

Ms. BETH PAULSEN-OLMSTEAD (Driver, Independent Transportation Network): Good morning.

Ms. RUTH BOWMAN: I am ready for you.

Ms. PAULSEN-OLMSTEAD: Hey, Ruth. How are you doing?

Ms. BOWMAN: Fine, thanks.

SHAPIRO: Today Ruth Bowman needs a ride from her home in South Portland. One of the ITN drivers, Beth Paulsen-Olmstead, helps Bowman into the front seat of a red, four-door sedan.

Ms. PAULSEN-OLMSTEAD: Watch that roof. Here comes your door.

(Soundbite of car door)

SHAPIRO: There's no blaring sign on the side of the car. It doesn't look like the handicap van has come to pick up the old lady. The idea is to make it look like your daughter or a friend has come by to give you a lift, which is why the drivers and their passengers become friends.

Ms. BOWMAN: Well, I remember how much sugar you put in your rhubarb.

(Soundbite of laughter)

Ms. BOWMAN: You don't have to do that.

Ms. PAULSEN-OLMSTEAD: No?

BOWMAN: No.

Ms. PAULSEN-OLMSTEAD: You're going to turn me healthy, Ruth.

Ms. BOWMAN: (Laughing) Yeah.

SHAPIRO: The ride service is a bit cheaper than a taxi because ITN is a nonprofit and some of its drivers are volunteers. Here in Portland, ITN charges a $4 pickup fee and then it's a dollar and a half for each mile.

Ms. BOWMAN: Monday morning I go to yoga. It's easy-does-it yoga. It's just wonderful. We pick up Margaret Raymond(ph). She's 95 years old. So we get a small discount when there are two sharing.

SHAPIRO: Ruth Bowman also uses the ride service to visit her husband, Dick, who lives in an elegant assisted living facility downtown. He moved here after he fell down several times at home and Ruth had to call an ambulance for paramedics to get him up. It's been tough for Ruth and Dick Bowman to keep getting around as they get older, but they say they do the best they can.

Ms. BOWMAN: I am 92 plus. I'm so proud of it.

(Soundbite of laughter)

Professor DICK BOWMAN (Retired Professor of English Literature): Well, she robbed the cradle. I'm only 91.

SHAPIRO: Dick Bowman is a character. Today he's wearing a red plaid sport coat over a green plaid shirt. He's got a plaid bowtie and argyle socks. Usually his pants are plaid too, but today just a drab khaki. Around his neck he proudly wears the medallion he got from alcoholics anonymous to represent his 25 years of sobriety. He's a retired professor of English literature.

Professor BOWMAN: They all call me the professor because when I got out of Mercy Hospital - a month's treatment - Dr. Stanley Evans who ran the hospital said, Professor, you're not here to correct our English. You're here to cure your disease.

SHAPIRO: Twenty-five years ago, it was his family that came together and demanded that he stop drinking. Two years ago, his children showed up again, this time to tell him it was time to stop driving. He'd had a couple of fender benders, the last one when driving his Volvo he scraped another car in the parking lot at his tennis club.

Professor BOWMAN: But it's much harder to get along without an automobile than it is without alcohol for civilization. It's a very automotive civilization.

SHAPIRO: Now he uses ITN to do errands and go to the theater. He gets rides to AA meetings, including the one he leads at the county jail. When Ruth saw her husband still able to get around even without his car, she started to think about giving up driving too.

Ms. BOWMAN: Suddenly, I woke up one morning and I thought, I don't want to be in an accident, I don't want to kill anybody. I've lost my self confidence on backing up and goodbye car.

SHAPIRO: Katherine Freund is listening to this conversation. She's smiling because this is why she created ITN.

Ms. FREUND: Did it make a difference to you to know that it was here when you were ready?

Ms. BOWMAN: Yes. Oh, it did. I wouldn't have had the courage to give up my car.

Ms. FREUND: You make me very happy. That's what we work for.

(Soundbite of laughter)

Ms. FREUND: That's wonderful.

SHAPIRO: Freund started ITN after her own son was struck and seriously injured by an older driver. The driver had dementia. Her son was just three years old. Ryan recovered. He's 24 now, a recent college graduate, and working to help nonprofit groups. But for years Freund wouldn't talk publicly about how it was the accident that led her to start her own nonprofit alternative to driving for older people.

Ms. FREUND: Because I wanted the issue to stand on its merit. I didn't want people to say, oh, she's just crusading because her little boy got hurt or she has a guilty conscience or any of that kind of stuff.

SHAPIRO: What she realized was that it does little good to ask people to give up their cars if they don't have an affordable reliable way to go door to door.

Ms. FREUND: I think that older people in their heart of hearts, if they're struggling with driving, somewhere they know it. There's this simultaneous denial and somehow they know it at the same time.

SHAPIRO: And that gets to the advice Freund gives for dealing with one of the toughest issues facing families with aging parents, how to have the conversation about when it's time to stop driving.

Ms. FREUND: To me the most important thing about this conversation is to have it in a loving and supportive way. A lot of people think that this needs to be some sort of an intervention where you get all the adult children together and you put your parents there and you confront them with this driving problem. Well, sometimes that needs to happen, but I think that that is extremely rare. I think really if adult children will say to their parents, I want you to be as independent as you want to be and I want to help you do that.

SHAPIRO: Freund says the key is to talk to parents before they have difficulty driving and to talk about what alternatives exist for when they do. Few communities have an independent transportation network or anything like it, but public buses might work or a door-to-door paratransit service for people with disabilities. Many people rely on rides from family and friends.

Freund and her siblings had this conversation with her own aging parents not long ago. It wasn't easy. But a few months later when her father's back problem stopped him from driving, Freund's mother surprised her. She had already figured out that one of their neighbors was a taxi driver who could help. Joseph Shapiro, NPR News.

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