Think about the last time your car went into the repair shop for a day or more. Remember the hassle? Even the simplest errands--going to the post office, picking up some milk or dropping off the dry cleaning--became an exercise in elaborate logistics. You had to walk, figure out the bus timetable, call a cab or bum a ride from a neighbor. You probably felt isolated, stranded and helpless, completely dependent on the kindness (and schedules) of strangers.

Now imagine that dependence stretching on day after day after day, with no end in sight. Then you get a sense of how seniors feel after they "retire" from driving. Life doesn't stop, even after driving does.

Seniors who give up their car keys don't give up going to the doctor, shopping, taking in a movie or attending services at church or synagogue. As one senior put it succinctly in a recent focus group on transportation needs, "To limit your driving is to limit your life." Fortunately, however, the choice isn't always as stark as it seems. Around New York State--indeed, around the country-- more and more programs have popped up to help seniors stay safely mobile, even after they choose not to drive. Often called "supplemental transportation programs"

(STPs), they provide an alternative to expensive taxis, spotty public transit, and busy friends and family members. STPs vary widely in their operation, organization and scope. But all have one thing in common. "We provide dignified, reasonably priced transportation for seniors who no longer drive," says Katherine

Freund, executive director of ITN America, the Federal Transportation Administration's model for sustainable, nonprofit STPs. "We have the potential to meet the mobility needs of seniors--and there is an enormous unmet need out there."

(Click here for a list of transportation alternatives in the Club's area)

Plumbing the Gap
As the U.S. population ages, more and more people face the difficult choice between safety and mobility. For seniors, the crash rate per mile climbs steadily after age 65--as do injury and fatality rates in those collisions. Older drivers have more crashes per mile than any other age group except teenagers. And in part because of the increased fragility that comes with age, they have fatality rates 17 times higher than those of 25- to 64-year-old drivers. Deteriorating vision, reduced muscle strength and flexibility, slower reaction times and the increased use of medications that inevitably accompany aging all affect driving ability. Of course, their effects vary widely from individual to individual. Some people can drive safely well into old age, especially with regular exercise, senior friendly vehicle designs, refresher courses in behind-the-wheel skills and self-imposed limits. But eventually age catches up with everyone.

According to the Beverly Foundation, a California-based research group, seniors can expect to be "transportation dependent" for between six and nine years of their lives. Generally, women must endure a longer period of transportation dependence, because they retire from driving sooner and live longer. Calculated from age 70, the average female gives up the keys at 81.2 years of age yet lives to 90.6 years, while the average man stops driving at age 81.5 and lives to 87.7 years. How many people fall into the transportation gap? The numbers may astonish you. Today, there about 4.2 million Americans age 85 or older. By the year 2010, their numbers will swell to 5.8 million--an increase of 28 percent. And with modern medical advances, their ranks will only get larger in time.

Enter the STP
How many of these folks can afford cabs? Walk to the bus stop? Or climb onto a bus once they get there? That's where STPs come in. For seniors facing those questions, simply knowing about alternative transportation programs in their area may make their driving decisions easier.

The AAA Foundation for Traffic Safety lists hundreds of programs now offering alternative transportation for seniors in localities across the United States. At least 54 operate in New York State, about one third of them in areas served by the Club.

A recent study sponsored by the AAA Foundation analyzed STPs in depth. In addition to identifying programs, examining their use and analyzing their organization and management, the researchers developed what they call "the five A's of senior-friendly transportation." The keys to a successful STP include Availability, Accessibility (easily negotiated stairs and sufficiently high seats on vehicles, for instance), Acceptability (clean, safe vehicles and friendly drivers), Affordability and Adaptability (transportation adjusted to meet special needs, such as wheelchairs).

Many STPs operate under the radar, with little publicity." We try to do a lot of outreach in the community, but advertising is expensive," says Linda Nadel of SNAP (Services Now for Adult Persons) in Queens Village, N.Y. "We mostly rely on local organizations, churches and community groups to get the word out. We get a lot of referrals from hospitals, physical therapists and social workers. Still, many people in the community have no idea that we provide transportation."

SNAP's fleet of four vans, one with a wheelchair lift, makes about 400 trips a week. Its paid drivers not only offer door- to-door service to stores, hospitals, doctors' offices and other places, but also serve as escorts and help carry packages on shopping trips.

"We help seniors get out of their homes and stay active and independent," says Nadel. "They remain viable members of the community."

Partially funded by the New York City Department of Aging, SNAP relies on other grants to cover operating expenses. Seniors make voluntary contributions (signs suggest $1.50 for a round trip) and schedule their trips a day or two in advance.

Seniors Driving Seniors
Unlike SNAP, not all STPs have their own vehicle fleet or paid drivers. For example, as its full name implies, Suffolk County RSVP (Retired and Senior Volunteer Program) on Long Island uses exclusively volunteer drivers--most, though by no means all, over age 55--in their own cars. "We pay them mileage, provide secondary insurance and hold a big party every year to thank them," says executive director Deborah Weiner. "We have a screening program for prospective volunteers and run a police background check on every one."

Relying on volunteers presents its own problems, however. For one thing, RSVP constantly recruits new drivers to fill growing needs. "We try to match up clients and drivers so that they have something in common, both geographically and emotionally," explains Weiner.

Then there's the problem of money. "People think of volunteers as free," explains Weiner." They're not. You need a strong operation for recruitment, training and scheduling, and that requires administrative expenses. We're always doing fundraising." Although contracts from the federal government partially fund RSVP, the program covers its operating costs by seeking donations from the community and support from local businesses that exhibit at the group's annual luncheon.

A Geographic Challenge
In addition to finding continued sources of funding, suburban and rural STPs face a problem not shared by their counterparts in more densely populated areas. For example, the Herkimer Office for the Aging operates a lone van that provides senior transportation in an upstate county along the Mohawk Valley.

"We're the narrowest, longest county in the state," says Mary Scanlon, the office's director." We cannot cross county lines. If a senior has to go to a neighboring city to see a specialist, we can't make it. If you had to go to Utica, for instance, you would be the only person to get a ride that day. Our goal is to provide transportation for the greatest number of people, so we have to have limits."

Unfortunately, the challenge of geography and political boundaries isn't unique to Herkimer County. The Beverly Foundation reports that about two-thirds of all seniors nationwide live in low-density suburbs or rural areas.

A Model in Maine
Katherine Freund understands all these obstacles, but sees none of them as insurmountable. With start-up funds from the federal government, Freund has developed a self-supporting transportation system intended to serve as a model for others around the country. The Independent Transportation Network (ITN) has been serving seniors 24 hours a day, seven days a week, since 1995 in and around Portland, Maine. Using a fleet of donated four-door sedans, paid as well as volunteer drivers provide rides to doctor's appointments, concerts and even horseback riding lessons.

"We offer dignified transportation as a consumer choice," says Freund. "It's a consumer-oriented, market-driven approach. And, most important, it's financially sustainable. Once it gets going, it rolls without any government money. "

How does it work? Seniors pay annual dues and become members of the nonprofit ITN. AAA members in Maine get a discount on their ITN membership--plus other benefits, such as free driver education classes if they volunteer. Seniors who use the ITN service pay for each ride, based on a combination of a flat rate per pickup and a mileage charge."Our fares are structured so that you pay more for a higher level of service," explains Freund. "For instance, if you call and schedule a pickup on the same day, it costs more money. But if you call the day before, it costs half as much."

ITN also offers innovative plans in which seniors can bank credits in a transportation account to draw upon as needed. For example, when they retire from driving, they can donate the car they no longer use to ITN. That way, the program builds its fleet at no capital expense, and seniors begin their membership with a fat transportation account. Adult children may offer "gift certificates" for their parents. Volunteer drivers can also participate in what ITN calls "Transportation Social Security." With every trip they drive, they accumulate credits for their own use in the future, when they eventually decide to give up the keys.

Freund has even recruited local merchants and health care facilities to partially subsidize the program. "The amount the merchant pays is the equivalent of validating a parking sticker in a garage," explains Freund. "Older people are consumers, too. They buy things, and it's in the interest of the merchants to encourage their patronage. It's a win-win situation."

Building a Network
If all this sounds complicated to administer--it is. That's why Freund and her colleagues have developed and refined software to make ITN administration easier." The software covers routing, scheduling, ride sharing, volunteer management, accounting, fundraising--everything," she says. "It contains all the basic elements to replicate an ITN affiliate and adapt it to a particular locality."

ITN America is now launching pilot programs in Santa Monica, Calif., and at least two other cities in other states. Ultimately, Freund envisions a national network of ITNs in which adjacent communities can link up to provide transportation across city and county boundaries. Seniors could visit medical specialists in other nearby towns with little or no hassle.

"Communities already support symphony orchestras and art museums," she says. "We believe that people will also support a program that gives seniors safe, dignified, reasonably priced transportation, because the entire community benefits. It helps seniors make good choices about whether or not to drive. And it keeps them living independently."

As Freund would put it, that's a win-win situation for everybody.