Tiffany (00:04.479)
Today's conversation is for anyone who gives care and feels stretched thin, especially when caregiving is part of both your work and your professional life. Our guest, Elizabeth Miller, is founder of Happy Healthy Caregiver and longtime advocate for helping caregivers protect their energy before burnout takes over. Elizabeth focuses on realistic, sustainable ways caregivers can show up for others without losing themselves in the process.

Elizabeth Miller (00:05.582)
you

Tiffany (00:32.159)
Today, we'll talk about what burnout actually looks like, why so many caregivers miss the early signs, and how working caregivers can begin to care for themselves without guilt. Elizabeth, welcome to the podcast.

Elizabeth Miller (00:46.504)
Thanks for having me Tiffany, I'm delighted to be here.

Tiffany (00:49.651)
Elizabeth, before we dive in, can you share a little about your caregiving journey and what led you to focus your work on burnout prevention and self-care?

Elizabeth Miller (01:00.686)
Well, essentially I created and dove into what I wish existed for me, Tiffany. I was a sandwich generation caregiver juggling work, juggling raising kids. had two kids in middle school. I had a full-time job supposedly in the peak of my career earning years. And my husband was as well. And we were juggling care for three older adults at the time, his mom and both of my parents. And I just felt like, why is this so hard? Why is it so hard to care for the people?

that we love and why am I feeling so invisible in this process as a family caregiver?

Tiffany (01:38.729)
three people at the same time, that's a lot of emotional load to carry, to be caring for those individuals all at the same time.

Elizabeth Miller (01:49.356)
Yeah, I think people talk about the physical demands and maybe even the invisible labor around caregiving, which there is certainly a lot of that. But it's hard to quantify and put numbers around the emotional load, as you said, Tiffany, like the times where we're just thinking about the people and worried about them and waking up at night and can't fall back to sleep. And it's hard to really quantify those.

Tiffany (02:16.677)
This is such an important topic and I am so excited to jump into this with you today. You work with caregivers every day who are balancing jobs, family responsibilities, and emotional labor. Let's talk about why burnout is so common, especially for people who care professionally. And what are the earliest burnout signals that you see caregivers miss?

Elizabeth Miller (02:44.588)
I think both for professional and for family caregivers, I certainly do, you know, I do think I draw some support to the professional care community, but definitely my focus is more on the family care community. But I do think the burnout is similar and that we get a lot of compassion fatigue, we're decision-making, we're learning things that we have never learned before, and it's...

but emotionally exhausting, it's physically exhausting. I know for me personally, like when I was caring, I just felt like I wanted to dive in and help these people. And maybe there's a little bit of a, you know, I can fix this type of mentality. And a lot of times we can't fix it. You know, we're making the best of a yucky situation. And it took me a long time to get at that point where I just felt like I could give, give, give. And realizing that no matter how much I gave, it was never...

gonna feel like it was enough because ultimately I couldn't fix these people, know, and I was really costing me a lot too as far as the health and happiness and having a ripple effect on my family and that was not sustainable.

Tiffany (03:55.871)
How do caregivers tend to minimize their own needs?

Elizabeth Miller (04:00.75)
Yeah, great question. You know, we lean in and we do a lot of things that we feel like are gonna help and we put our own lives on the back burner. We don't go to our wellness visits and our appointments because we're so focused on helping somebody else. And it just feels like we don't have time for that.

We just can't, like there's not enough hours in the day to even do what we're already doing. And so that we start kind of shaving off time for ourselves. And that has a big cost in the long run. And that's what I had to realize is that, you know, what I was doing was not sustainable. I needed to put some process and some systems in place so that I could find more white space and more breathing room in my life and start to feel like myself again. I think a lot of caregivers, both professional and family,

We look in the mirror and there's a day where you just like, don't even recognize who you're seeing there anymore. And you're like, enough, enough already. Something has to change.

Tiffany (05:05.779)
I always talk about the importance of giving yourself grace in caregiving. And I saw that you posted on social media the other day that giving yourself grace isn't selfish, it's survival. And I love that. Can you talk a little bit about how giving yourself grace is not selfish?

Elizabeth Miller (05:10.328)
Yeah

Elizabeth Miller (05:26.646)
I think because there's so much that we're doing for other people, the emotions around guilt come up all the time. And there's actually nothing I can share today or when I speak and do other things. There's nothing I can say that is not gonna make the feelings of guilt start to surface. But I do like to say that we can replace that G word, that guilt word with grace because...

we are doing the best we can. We are making the best decisions with the information that we have at the time. We are sometimes put in impossible situations where we're asked to do things that we never even dreamed we would be doing. And it's just hard. It's hard. So I think if you can look in the mirror at night and you think, you know,

Gosh darn it, I gave it my all. I did the best I can today. I certainly hope that grace is something that you can say, I'm not gonna feel guilty about this anymore. I'm gonna give myself grace the same way that you would a best friend or somebody else who was going through a similar situation.

Tiffany (06:29.193)
You talk about how we're sometimes put in these impossible situations and that's exactly what it feels like when you are a caregiver. And sometimes we're thinking about, want to be the best caregiver possible for this loved one. How does being good at caregiving actually increase burnout?

Elizabeth Miller (06:49.966)
Well, perfectionism can be troubling in all kinds of different situations. And it's not attainable. Sometimes we can lean in and maybe feel like we're being perfect in one area, but we say yes to one thing, we're saying no to something else. I had felt that we hear the analogy all the time about the oxygen mask, that we can put our oxygen mask on ourselves before

helping other people. And I didn't love the analogy, Tiffany, and the reason why I didn't is because that's a one-time event, right? When someone's telling you to put your mask on, there's turbulence. It's very obvious. You're in a crisis situation. But when you're in a daily cycle of care and over and over and over again, there's nobody kind of coming over the loudspeaker telling you to do that. And there's all of these competing priorities. And so the analogy that worked best for me was

feeding a nest of hungry birds and really trying to visualize all of these competing things, my job, my relationships, my kids, my pets, my house, my care recipient, and that they were pecking away at me and I was disappearing. And it wasn't until that kind of really entered my mind and I thought, wow, I'm not gonna be able to keep showing up for the people in my nest if I don't go and take some nourishment myself. And so that...

thinking about the ways that I could energize myself and nourish myself so that I could show up as the caregiver that I wanted to. Not necessarily the perfect caregiver, but the one, the good enough caregiver and the good enough employee and the parent and wife that's also showing up. And so we wear a lot of different hats. And so we have to be intentional about how we're spreading out our time and how we're not losing ourselves in that process.

Tiffany (08:46.793)
really love that analogy and I think it works perfectly for the caregiving world. Can you share a little bit about how burn up burn out shows up differently at work versus home?

Elizabeth Miller (09:00.27)
Yeah, know, burnout, I've kind of experienced it professionally, experienced it personally, I've had it in caregiving. I'm in a different caregiving season now. I shared in the beginning that I cared for my parents and my mother-in-law. Sadly, all three of those folks are deceased now, but I'm a primary caregiver for my older brother who is neurodivergent and...

He's on the autism spectrum, born with an intellectual and developmental disability. And so the burnout has started creeping back. And what surprised me is that even as an entrepreneur who's working, you can experience burnout. And in some ways, it's really different versus my corporate job, where people could back me up and I had paid time off. as an entrepreneur, I'm not doing the work. The work is piling up. And so I do think that

all of that can be compounded together. Because we can't really specify, you know, our work lives and our caregiving lives really start to blend together because caregiving doesn't just happen outside of the work hours. Like it's all encompassing. And so you really do have to be intentional about seeing those warning signs. And for me, burnout looked like...

Like I said, not recognizing myself in the mirror, I would cry very easily. would, you know, started losing interest in the things that I enjoyed or just saying, I don't have the energy to do that when I would just be all over it, you know, in the past. And, and sometimes it was physical symptoms as well. Like I was had a face full of acne, you know, I had heart palpitations and panic attacks. I was gaining weight. And so there was

a lot of different things that were happening. And so I will say this last round of burnout that started peeking through, once I had experienced it, I started to recognize and I thought, no, here I'm going again, like we gotta do something different. And what I'm also noticing is that some of the things that worked for me in the past for self-care strategies weren't necessarily working this time around. And so having to kind of get creative and...

Elizabeth Miller (11:16.814)
explore those different ways that could help me.

Tiffany (11:21.095)
I like how you've talked about how there's different ways that burnout can affect you. It can look different in different ways, whether it's physical, emotional, not enjoying the things that you once enjoyed. And then also saying that even things that maybe were helpful before maybe aren't helpful now. So it's good to also say, you know, we have to be kind of on the lookout for, you know, am I experiencing burnout?

what has worked, maybe should I try something different if it's not working now? And just being willing to try different things and also see that if you've gone through caregiving with one family member and you felt a certain way, you might feel a different way when you go through it a second time and a third time. So I think it's important for us to kind of always be on the lookout of how am I being affected because just like you said earlier, you can't, you know,

we have to make sure as the caregivers that we're taking care of ourselves.

Elizabeth Miller (12:18.998)
Yeah, it's critical. What we don't want to do, Tiffany, is make our situation even worse, right? If we stop investing time in ourselves, in our own health and happiness, it just compounds everything. It makes everything a lot worse. And while I believe that every human out there deserves to be nourished in self-care, sometimes that reframing that to say, no, the whole system breaks down. I have to do this for somebody else. I hope that you get there because you think that you deserve it. But sometimes,

Tiffany (12:25.173)
You're right.

Elizabeth Miller (12:48.076)
we do have to kind of get there in thinking that the whole system starts to crash down. And I like to suggest that caregivers build up a closet of different self-care tools because just like when we put on our clothes every day, it's how we feel, what's the weather like, what are the activities that we're gonna be doing.

And the same thing is true when we're thinking about our self-care strategies. so having a wide variety of things that are different lengths of times, different moods and so forth, gives us a variety of things that we can try on. And your closet is gonna look different than my closet. And my closet in this caregiving season to your point might look different than it did in last season and the styles change, right? And we kind of have to just ebb and flow through that. And so getting curious.

I think is critical about the things that are really gonna feel good for us. And my definition of self care that is shared, and I keep kind of refining it, is that self care is anything that is going to energize me, both physically and emotionally, it's gonna give me peace of mind so that I can sleep at night, or it's just pure joy. And we all need to have combinations of all of that in our life.

Tiffany (14:09.589)
Caregivers here take care of yourself all the time, but that advice often falls flat. Why does traditional self-care messaging not necessarily work for caregivers?

Elizabeth Miller (14:22.06)
Well, I call that shoulding, that people were shoulding all over me, like, you should be doing this and you should be doing that. And it's never, I feel like it's never gonna be authentic and received well if it's not necessarily spoken from another family caregiver, because I do feel that self-care while you're caregiving is different. The things I used to do before for myself and the things that I do while I'm caring for somebody,

I've had to adjust them and modify them. A lot of caregivers don't have the freedom to just drop everything and go whenever they want or travel or maybe finances are tighter than normal. And so a lot of the media messages about self-care may not necessarily fit. Like it's not just weekends away and nights on the town. It might be a game night with people and or it could be

getting outside and just feeling like there's a bigger world out there. I was really hyper-focused initially in my caregiving season on physical self-care. And I think that's kind of, know, again, what the media portrays about eating right and exercising, but it's so much more than that. And so through Happy Healthy Caregiver and the content that I share and talk about now, I really recognize eight different categories of self-care, physical certainly being one of them.

but not the only one. There is the emotional side. There's the financial self-care, spiritual, practical, intellectual, social, and professional. And it's a combination of all of those things that we might need certain things at different times. And that, again, helps kind of categorize our closet of tools a little bit.

Tiffany (16:10.737)
I agree with you, think self-care really can go beyond rest and relaxation. It can be like you said, anything that might bring me joy can be considered self-care. You also talked about how not everyone's able to just drop everything. And so that got me thinking about what does realistic self-care actually look like for someone who's working full time?

Elizabeth Miller (16:37.002)
It takes intention. Like you're never going to find the time to care for yourself. You're going to have to create it. And I remember just feeling like, my gosh, something has to change. I'm losing myself. You my health is suffering. I'm not recognizing who I am anymore. And literally sat down with the whole calendar and thought, I got to figure out how do I can put more time into my life for me and my relationships that I, my other relationships that I care about.

and started to do this whole exercise, frankly, of where I could infuse more me time in my life. And I think that was a really good exercise to go through. one that I sometimes coach other caregivers to go through because they feel like, and people are listening to this and like, I don't have time for that. And that, I push them because I'm like, you cannot not have time for it because...

it will come back and it will bite you. So let's work together to figure out, know, what you can say no thank you to right now, you know, in this season of caregiving. What are your values and where do you want to put intention on and how can you divide and conquer so that you can have more help from your care team, whether that be, you know, and your care team can be comprised of your family and friends, your loved ones, family and friends, but also professionals as well.

Tiffany (18:03.861)
Burnout prevention isn't just about self-care like you've talked about, it's also about support. What makes asking for help so difficult for caregivers?

Elizabeth Miller (18:15.01)
We all, I think, kind of go through this phase of, can handle it. You know, I can do it. And there's the other analogy of the frog in boiling water, right? Like if a frog jumped into water that was already boiling, they would immediately jump out. But when you are slow boiling, if that frog went in and it just slow boiled, that's what it is like for caregivers. And a lot of times we don't know that we're burnt out until we're already there. And that's where I think having support around us

family and friends and community support is everything I think in caregiving. Like I have felt so seen and so validated by other family caregivers who were echoing some of the feelings that maybe I was embarrassed or ashamed that I had. And so support is definitely out there. And I think that until we...

We recognize that we are family caregivers, that we accept that role, that we start to Google that term and start to find the support, whether it's online and in our local areas. It's so critical to start to expand our support because not only does our care recipient, our loved one need a care team, but we also need our care team as primary caregivers and support caregivers so that we can mitigate burnout.

Tiffany (19:35.027)
And I think sometimes the answer is sometimes saying yes to less. And so I was actually really excited to see that this is also a mantra that you also have. Exactly. In the caregiver's caregiving setting, boundaries can feel like you're letting someone down. How can caregivers set boundaries that feel respectful instead of selfish?

Elizabeth Miller (19:40.782)
Mmm.

Elizabeth Miller (19:45.312)
Yes. Are you my doppelganger, Tiffany? Yes, like yeah.

Elizabeth Miller (20:02.914)
I think one of the biggest lessons that I learned through caregiving, frankly, is learning how to let go. We want to control things so that we can control the outcome of what's going to happen. And then we realized that we don't really have that much control over anything, but our own choices and the decisions that we make. so that was a critical point after I had started to excavate and claw my way back from caregiver burnout, particularly the first time, is that

You know, I needed to set some boundaries in place that what I was doing in my life was not sustainable and that I was going to burn out and I wasn't going to show up as the as the mom, the employee, the wife, the caregiver that I wanted to the friend, you know, in my family. So one of the boundaries that I know, like early on that as an example was my mom had never really lived on her own and went after my dad passed away, we moved her to the Atlanta area from Florida.

And she wanted us around her all the time. We made her feel better. I had a full time job. I had kids trying to get my own groceries and food on the table. And I wanted her to be happy. And she was grieving. And I was grieving, of course, the loss of my dad, I think. I honestly don't even know if I had the time to even grieve that properly. Just kind of thrown into a caregiving situation. But I had to have like a...

a vulnerable conversation with my mom and just say, look, mom, like I, you know, I, I love you. I care about you. And I'm, know, what we're doing is not sustainable. I just can't come over every time that you want me or every time that you need me. And some of the things that she would consider a crisis were not really true crisis situations. You know, she'd be out of ginger ale or she couldn't get on her wifi or she wanted me to, you know, help her order something online.

And so sitting with my family and kind of figuring out like I need to carve out a good chunk of time for mom, you know, every week, like what can that look like? Is that the time mom had lived nearby and assisted living? And so we came up with Wednesday nights. And so Wednesday was my night. I just didn't plan anything else. I just knew right from work. I was going to go over to my mom's, you know, I gave her a pad of paper. said, mom, when you think of things that you want my help with, please just write them down and

Elizabeth Miller (22:28.44)
We're going to try to knock out some of these when I come over on Wednesday, and then we're going to have some, we're to do something fun together. You know, something we might color or play skip or, or watch a Netflix show or, or something like that. But that really helped me park that traffic and that guilt all week long to say, no, I've got Wednesday. I've got Wednesday is my mom night. Like that, that's what, and I'm not saying that it never happened other times. Certainly we had doctor's appointments and

And there were true crisis situations where I needed to be there, but that really helped me compartmentalize it and set the boundary. And was it perfect? Did she love it? Not necessarily. You know, she still wanted it the old way. Who wouldn't? But it wasn't, it wasn't sustainable.

Tiffany (23:13.341)
I love the idea of the notebook with your mom because that's also making sure that when we are together, we're doing things that she really wants us to do. Things that she thought of this week that she wants us to do or connect on or needs help with, you know, whether it's fixing the remote or, know, whatever it might be, connecting to the Wi-Fi. So I love that idea of having the notebook and then you have this designated time that's your time to be together and enjoy one another.

Elizabeth Miller (23:38.188)
Right, and then there were times where my brothers might visit or somebody else and she could certainly look at the notebook and maybe they could handle one of those things. Did it have to be me all the time to check everything off? And it was a good system for us. It worked out pretty good.

Tiffany (23:54.869)
So sometimes it's about advocating for yourself in regards to being a caregiver and thinking about burnout. Can you talk a little bit about how professional caregivers can advocate for themselves at work?

Elizabeth Miller (24:08.62)
I think we all need to advocate and be real and be genuine as much as we can at work and at home where sometimes I think we have to let the crack show of what's going on in our life. They're not living our lives exactly like we are. And so we have to share what's going on in a very respectful, and especially if you're in a professional environment, but to share some of that impact.

so that people can understand what it's like to be in our shoes and maybe even some suggestions of things that could be improved upon or changed. And I think that's how change happens. Advocacy is story sharing. And that's part of the reason why I love doing the podcast, Happy Healthy Caregiver, because I wanna highlight other people's stories and highlight the strategies and the...

the self-care tips that are working for them, the resources that are helping them, because that's how we strengthen together. without advocating for that, then change doesn't happen. And we need change to happen. We're outnumbered, know, professionally and family caregivers. There's more people who need care than there are people who can help care. And so we've got to figure out how we can make these tweaks and these changes so that we can, you know, live more vibrant lives.

long term.

Tiffany (25:35.985)
What does sustainable caregiving look like over the long term?

Elizabeth Miller (25:40.632)
Great question. I I love the word, I love that word sustainable because we can do anything kind of gritty and raw for a short term period, but you know, the average caregiver is a caregiver for more than four and a half years. Like you can't be gritty and just all in for that long. so systems are what's important and figuring out, you know, again, who's on your care team, who's on your loved one's care team. And I think that is exploring the help that's available for out.

that's out there. One of the things that I suggest that people do is plan for the, be proactive about planning for a crisis. Start to think through the different situations. Look ahead about what might need to be true a year from now or a couple years from now and what are some steps that you can take now that your future self is gonna thank you for.

We need backup plans as caregivers. Like it's it's unrealistic to think that we can be showing up for somebody all the time. And I think that's where we need professional resources like you know OTPT home care health care hospice and so forth all of those professional resources and some of them requiring a home care requires an assessment to be done and so.

One of the things you could proactively do so that you are able to meet, what if you got free concert tickets to the concert you've always been wanting to go to, or you had a wedding coming up? You don't want to have to say no to these things. And so having a backup plan where care is in place is so vital and get the home care assessment done. Get it done so that you have a plan so that when you need backup care or you need respite, you have that option available to you.

Tiffany (27:32.563)
I think that is so important to have a plan, have a backup plan. Like you said, you may need respite and it may not be something you're using all the time, but get that set up with the company so that you know who you're reaching out to when that amazing concert comes up and you really want to be able to go. And I think it's so important to think about what are we going to do in different situations? Who else could help if there was something that came up? Who could help? Who can kind of be on the list of people that are available?

Elizabeth Miller (27:49.878)
Exactly.

Tiffany (28:02.441)
And sometimes it might be the professional caregivers coming in and that's great. Getting respite care is something that can really help when it comes to burnout and helping families kind of continue through this process.

Elizabeth Miller (28:16.79)
Yeah, sometimes, you know, it can be really hard for older adults and care recipients to be able to accept help from other professionals. And so one of the tips that I give to the caregiving community is to get them used to having people around helping in other ways. So maybe you can have a dog walker or someone to come in and do laundry or grocery shopping or lawn care and, you know, kind of use that as an entry point before.

getting somebody to do more of the personal care items can be tough. And sometimes you've got to find the right fit and do your best to kind of ask questions, to find if they have some commonalities and things like that. But I think that that's one of the big pushbacks I get is that they don't, from caregivers, that their loved ones don't want to accept their help. And then again, this is where I go back to, well, what do you want to be true? And sometimes you do have to let those cracks show of what's going on in your life.

How is this situation affecting your job, your kids, your marriage? And let them know that this is not sustainable and that we do have to do something differently because that's the definition of insanity, right? Doing the same thing over and over again, expecting things to be different. And so hopefully, as long as they can cognitively reason with them, mean, certainly there are people who can't grasp that due to their cognitive ability, but.

Hopefully letting some of the crack show, getting them introduced to some help makes that go a little bit smoother. And maybe again, it's around the house care before it's the caregiving care and getting rid of some of the things that are on your plate that are related to some things so that you can free up some time for more of the caregiving tasks.

Tiffany (30:04.775)
I love the idea of having people come in and maybe take over some of these additional tasks. Like you said, it's great to maybe get your loved one comfortable with maybe someone coming in. If there's someone that comes to do laundry or someone that's doing the grocery shopping, I think that is a really, really great suggestion that can help maybe having professional caregivers come in. I think that's great. Can you share with our listeners just a little bit about happy, healthy caregiver and how they can find more information?

on that.

Elizabeth Miller (30:36.43)
That's my favorite question, Tiffany. Thank you. Happy Healthy Caregiver, you can find it at happyhealthycaregiver.com. Essentially what I do is provide education, support, and resources for family caregivers. You'll see hopefully empowering social content. I've got a weekly email list where I share something happy, healthy, and care related. I have a Just For You Daily Self-Care Journal for people to help prioritize their own health and happiness.

How I make a living primarily is through speaking, speaking at conferences and for companies and associations and doing different partner collaborations where it makes sense. So we'd love your support and yeah, check it out. HappyHealthyCaregiver.com.

Tiffany (31:23.093)
As we come to a close, what is one message you want caregivers, professional and family alike, to hear when they're running on empty?

Elizabeth Miller (31:31.086)
I think we can do hard things. know we can do hard things, but we don't have to do them alone. Start to seek the support so that you feel like you're not alone out there and that you've got resources and people who are going to understand and maybe even offer some suggestions and tips if you want those. But sometimes it's just the listening ear.

Tiffany (31:54.933)
Elizabeth, thank you so much for your time and your expertise today with us.

Elizabeth Miller (32:00.12)
Thanks for having me.