We live way out in a very rural county. We don't have trash pickup or recycling, even. I have to carry trash to a collection point and bring the recycles to town. When my hubby is in the hospital, it's a 200-mile round trip in a day. Keeping a full day at work and tending to him in the evenings just isn't possible even if there were public trans services. I'm up at 5:30, out of the house by 6:45 for a 65-mile one-way commute, at work by 8, leave a few minutes after 5, then there's a 65 mile trip between High Point and Durham. Then there's a 55-mile trip home. I arrive to tend to the house and the dogs around 9:30 or 10 in the evening. Then there's household stuff to do before trying to catch a few hours' fitful sleep.