Working Caregivers: The Invisible Employees

The Hidden Cost of Putting Yourself Last as a Caregiver

• Selma Archer & Zack Demopoulos • Season 1 • Episode 40

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As working caregivers, we often focus so much on caring for others that we forget one critical truth: caring for ourselves is not optional. In this episode, we sit down with psychiatrist, coach, and financial wellness advocate Dr. Billina Shaw to explore the often-overlooked physical, emotional, mental, and financial impacts of caregiving. Through personal stories, professional insights, and practical wisdom, Dr. Shaw helps us understand why self-care is a necessity—not a luxury.

We also dive into the connection between mental health and financial wellness, the challenges caregivers face in the workplace, and how shifting our mindset around money can reduce guilt, shame, and stress. Whether you're currently caring for a loved one or preparing for the possibility in the future, this conversation offers valuable perspective and encouragement for the journey ahead.

Episode Highlights

[1:40] - Meeting Dr. Billina Shaw and exploring the health impacts of caregiving

[2:23] - A personal family story that reveals the physical toll caregiving can take

[4:49] - Why self-care is non-negotiable for caregivers

[6:25] - Navigating grief, loss, and creating meaningful family rituals

[8:20] - Why so many caregivers struggle to ask for help

[10:24] - The connection between caregiving, mental health, and workplace performance

[13:58] - Understanding the financial impact of caregiving and family caregiving costs

[16:30] - How financial wellness and mental wellness influence each other

[20:21] - The most important financial question every caregiver should ask

[25:15] - Dr. Shaw's powerful advice for caregivers: invest in yourself

[27:29] - How to connect with Dr. Shaw and continue the conversation

Links & Resources

About Dr. Billina Shaw

Dr. Billina Shaw is a Yale-educated, triple board-certified psychiatrist specializing in child, adolescent, and adult psychiatry, as well as addiction medicine. She holds degrees from Yale University, the University of Pittsburgh School of Medicine, and the Johns Hopkins Bloomberg School of Public Health. Throughout her career, she has served in leadership roles across government, private organizations, and her local church.

Dr. Shaw is also the Founder & Coach of Freely Flourish Financial, a financial wellness practice inspired by a powerful realization from her clinical work: money isn't just math—it's a combination of numbers and meaning. Recognizing that practical financial knowledge alone rarely creates lasting change, she developed her proprietary Aligned Health & Wealth™ framework to help individuals strengthen both their mindset and financial strategy. Through this work, she empowers clients to move from feeling anxious and stuck to living with greater purpose, peace, and prosperity.

If you enjoyed this episode, be sure to follow the podcast and leave a review. Remember to check out our website at invisibleemployeeadvocates.com for more resources, and subscribe to our newsletter for updates! We’ll catch you in the next episode.

Billina Shaw:

If someone say ends up in debt because of a catastrophic event and they need to take on some debt for caregiving, why carry the additional shame around money when they're just working on keeping their family member alive? That that debt has significant value. I don't want people to feel like they have all of these swirling feelings around negativity if it's truly aligned with their values and their goals and their vision. So, the most important thing is understanding your why for your money.

Unknown:

Did you know that in 2020 there were 53 million caregivers in the United States, and by 2025 this number is expected to grow to 62 point 5,000,073% of these caregivers also have a job. They are called working caregivers, and they are invisible because they don't talk about their caregiving

challenges. Working Caregivers:

The Invisible Employees is a podcast that will show you how to support working caregivers. Join Selma Archer and Zach Demopolis on the Working Caregivers The Invisible Employees podcast as they show you how to support working caregivers.

Zack Demopoulos:

Good morning, good afternoon, good evening. Thank you for joining the Working Caregivers Invisible Point Podcast, my name is Zach Demopolis.

Selma Archer:

I'm Selma Archer.

Zack Demopoulos:

Hello, Selma Archer. How you doing today?

Selma Archer:

I'm great, Zach. How are you?

Zack Demopoulos:

I'm doing fantastic. I can't wait to talk to our guests that you've brought to us, Elma. So, please let's bring her on.

Selma Archer:

We are so excited to welcome our guest today, Dr. Balina Shah. Hello, Dr. Balina.

Billina Shaw:

Hello, someone's act, so great to be here.

Selma Archer:

Well, we are excited because you have such a wealth of information to share with our audience today. So, we'll just plow right into it. You are a medical doctor, as well as the psychiatrist, so you are the perfect person for us to speak with, in terms of both the mental toll and the physical toll that caregiving has on an individual. What do you see as some of the most challenging health concerns that are facing caregivers and working adults today,

Billina Shaw:

sure. So, thanks so much for this question, and thanks for having me. You know, as a psychiatrist, as now a coach, as well. I think that there are so many important things to discuss in this topic, one of which is just in general, caregiver health and mental health. So, I mean, I'll start with a story, you know, as a psychiatry as a specialty in medicine, and we learn, you know, we go through all the regular medical training, just like everyone else. You know, I've delivered babies and scrubbed into surgeries, and then at the end of the day I decided that I wanted to focus on learning how to help people both with their mental health. Mental health can impact our physical health so, so frequently, like our neck is not just, you know, a random little pendant, like our whole body is connected, right. And so, you know, my grandmother actually was a caregiver. My grandmother was much younger than my grandfather. However, she ended up passing away before him. The primary reason that I strongly believe is because of the physical toll of the caregiving, my grandmother was at least 10 years younger than my grandfather, and she ended up passing away from an aortic aneurysm that ruptured.

Selma Archer:

Wow,

Billina Shaw:

you know, I just think about just the physical toll, and obviously that is a medical condition that you know is not specific to caregiving, but the high blood pressure, the stress, it's a lot on anyone's brain and body, and so the first thing is, you know, first message for anyone, and for anyone who's caregiving, is that self care isn't, isn't a negotiable, it's not an option, and it's oftentimes people feel like caregiving is really a calling, it is part of their familial responsibility, but we are our own responsibilities too, and just to remember that, because at the end of the day, you can't feel, you can't pour from an empty cup, and you have to be here to be able to provide that care, and so figuring out that that balance and striking that balance is so, so important.

Selma Archer:

I just wondered, in your work, how often have you had to have that conversation with caregivers? Like, is that something that you see recurring, you know, more often than not? Yeah, because I know I struggle with the same issue of stopping taking care of me, so that I have the energy to take care of those around

Billina Shaw:

me. Mean, there's a reason why, when we're flying, that they say to put that mask on first. It's very common to try to not to, and for many reasons, including that our sense of identity is often tied up into the caregiving, our identity as a family member, a daughter, son, our identity as just somebody who loves, you know, and this is how we feel that our expression of love is coming through, and so it can almost feel like we're sacrificing or pulling away from that person or not loving that person, but really, I think that loving ourself really helps to love that person in a different way.

Zack Demopoulos:

Yeah, Dr. Blaine, I love that you shared about your grandmother. I want to share with you that I ran a home care business for 13 years, and there were a number of cases where and it usually was a woman who would hire us and she would pass before her husband and they were younger than her husband or spouse and it was tragic, I mean, How do my share a little bit more about what happened when your grandmother passed away before your grandfather, how does a family bounce back from something like that?

Billina Shaw:

You know, we as a family have started a new tradition. So, she actually, my grandmother passed away a couple days before, shortly before Christmas, and you know, just around obviously holidays, there are, you know, gathering moments, but oftentimes a source of grief because of the memories of the family members that aren't with us. One significant thing that I have learned in my psychiatric training around grief and loss is to understand how to use rituals and creating new rituals sometimes, so we actually created a ritual around my grandmother's loss of cooking spaghetti, because that year, you know, for Christmas, you know, you often have a big dinner, and we just had that big dinner at Thanksgiving, and the family looked around each other and said, Does anyone feel like cooking real big dinner, and we're like, no. And so we actually, from now on, from then on, just started cooking spaghetti, maybe we get fancy and do lasagna or something, but in our honor. But the important part of that story is that it was, it's a reminder, and a familial reminder that togetherness is more important than the old ritual routine, and that the work or the labor of the quote unquote fancier meal, that labor is not necessary for community and for family.

Zack Demopoulos:

Oh, I love that. Thank you for sharing that. I also, in our home care experience weeks, we normally would get a phone call from somebody where it's almost too late, so they're they should have asked for help earlier, right? So, and Selma and I see this all the time, where caregivers don't ask for help. In your experience, why do you think that

Billina Shaw:

is? I think a lot of.. there's a lot of reasons why people don't ask for help. I feel like there's a cultural element to it. There's this, this cultural piece that says that I am expected in my cultural role as a fill in the blank, whatever that role is, a spouse, child, whoever that is, is that I am expected to provide care in a way that is perceived, you know, but there's no specific rule, but there's just this, there's this understood expectation. I also think that our society has been so hustle, quote unquote, independent, all these things that say that I'm supposed to do it on my own, that there is a sense of failure or inadequacy if we say that we actually need help. I also think that at the end of the day, it's just it, we have created this this concept of needing to be superhuman and that there's almost sometimes a separation of the humanity and the emotional element of caregiving versus the physical elements of caregiving, and being able to stop and say that I was still able to be a caregiver, and, and I'm giving care without bleeding myself, literally, in my grandmother's case, really, right? Like, but, but you know, bleeding myself out, and that you can still give emotionally without draining yourself physically, and really just starting to. Understand that

Zack Demopoulos:

those are great points. Thanks for sharing.

Selma Archer:

So, as we talked about before, Dr. Molina, our audience includes employees, employers, caregivers themselves. How do you see mental health impacting workplace performance, relationships, and overall well-being,

Billina Shaw:

so as a child psychiatrist, there's this little cartoon that I've often seen where kids are supposed to go into school and they're supposed to learn and figure out everything they need to be a functioning adult when they're carrying the baggage of anxiety, depression, food insecurity, housing insecurity, all of these other mental bags and baggages, and we're expecting kids to grow and learn that way, which obviously is not realistic, and I believe it's the same with employers that employers are expecting people to come in and be these robots, and we just talked about these robots, and this physical, emotional - there's a physical being that just goes, goes, goes without the emotional connection, but at the end of the day, people, because where the workforce is made of people that those people are going to feel drained and not able to be as creative and complete things and distractible and concerned and thinking about what are what are they need to be doing at home and and just not able to focus and you know, you know, I just think about even just the concentration symptom in, in my field. A lot of times people will say, "Oh, I must have ADHD because I can't focus, but concentration symptom is a symptom of attention deficit hyperactivity disorder, depression, anxiety. There are so many different things that are lack of concentration can come from, and so just thinking about just that one symptom alone, concentration, which is what we all need to have at work to do, do our job, and just how that can pull people away. And so when you think about just all the other emotional pulls and drains, the physical time, the things that are related to caregiving, the coordination of the vendor supplies, appointments, those all those people work nine to five. So, slipping in that call, slipping in that coordination, being a whole logistics manager, project manager, while you're possibly being a project manager at work, like it's really not quite feasible to do both well, and giving people grace to be able to have that time and understanding can be so important.

Selma Archer:

I really like that analogy that you started out with, with the classroom, and that's so true. My husband's educator was in the classroom for many, many years, and he told me a lot of stories about, you know, children coming in, they're not responsive to, you know, the work, they're totally disconnected. And he said many times you would ask them, did you have breakfast today, and most often it would be no, there was no breakfast, we didn't have money for breakfast, so he'd have to, you know, make sure they had a meal before they could start taking in the classroom day, so that is just so true. And I never, I never put the two together like you just did with the workplace, and you know, being able to have all those things satisfied, so that you can do the best job possible that day, so that's a great analogy. I really like that.

Billina Shaw:

Thank you. I mean, you think about it, that's physical fuel, but you think about the emotional fuel as well as the physical fuel together. But how are we supposed to be running anything without any fuel,

Selma Archer:

exactly?

Zack Demopoulos:

Yeah, some and I rarely have conversations with guests, where we don't talk about all four impacts of caregiving, and you've covered three of them pretty well, physical, mental, and emotional, but look at you, you're also doing financial, so I mean, you're like amazing. Do you do anything besides study? I'm just curious, I mean, I just amazing, but financial is also very critical, and so can you share a couple of things. One, what do you feel is the financial impact of caregiving on mental health? And two, tell us about what you've created your company, The Freely Flourish Financial. Love to know how you came up with that name, what you can do for your clients is specifically working caregivers.

Billina Shaw:

A lot of times finances seem to be in this whole other silo, this whole other bucket that's independent of mental health, and I started to realize I'll just share another story, is that. I actually was an a federal employee, and I ended up losing my job, and I became very anxious, because I'm thinking, well, where's this money coming from? How I'm going to pay my bills, but I also had started to repair myself, and this is actually a mention of, you know, of caregivers, because it's also important to think about that preparation too, but I had started to prepare myself for the potential of side job loss, and I had a consulting company and a consulting contract that was able to pay my mortgage for a year, and I was still anxious, though, and I started to realize that this isn't just about the numbers, this is about the meaning, this is about what my perceived securities is about, my relationship with money, and I started to realize that mental health and money have this bi-directional impact. I would always try to help people with budgets and things, and realize that didn't work if I just looked at the money, just looked at the numbers, but had to look at what's underlying that, and the meaning, and so mental health and money, or find our wellness, and financial wellness is really just a part of wellness. There's something called eight dimensions of wellness, it's a very popular framework for how to consider wellness, and actually one of them, you mentioned several of them already, but one of them is financial, but I wasn't trained really to think about that, other than maybe case management, and making referring people off, but just that, that feeling around money and the conceptualization of wellness is still important, and when you think about caregiving, it is a direct, it could, it can be a direct possible threat to finances, and often is I have family members who have lost homes because of caregiving, because of the inability to work, and things of that nature. So, especially if you don't have a significant nest egg, we all know that long-term care is so expensive, and nursing homes and other skilled facilities are very expensive, and the insurance structure and infrastructure doesn't often pay for that, or to put someone in a setting where you're a loved one in a setting where you feel that the quality is of that the similar quality is what you would like to provide. Also, there needs to often be financial resources. I think about also sometimes the guilt and the shame. If someone's unable to care for someone like they would like to in the home, and they need to have support, and that support maybe isn't the same quality. There can often be guilt and shame, and on all of these feelings around money. So, to summarize, where is it? There's there's a financial drain that can happen with caregiving, and then there's also the guilt and shame if someone doesn't have all the resources that they would like to have around around caregiving, and the work that I do helps people understand that even if they don't have everything that they want at the moment that they have the ability to still thrive and grow, and that I like to say that I try to see money as a puzzle and not a problem. How do we get to the answer, and how do we find the answer? And sometimes when you're in the middle of doing a puzzle, sometimes it's just frustrating, right? Oh, is it supposed to go here? No, it doesn't go there. And sometimes just put it down, and you make a mistake, but then you pick it up, you put it down somewhere else, and you keep fine, you keep working until you find it, and eventually it's very fulfilling when that puzzle is put together, and so I like to say the same with money, but especially the caregiver, that it is important to think about how do you start shaping those puzzle pieces in advance? How do you start understanding what kinds of future needs there may be? I have actually purchased a home that has more space than I need in case I need to support family. I've purchased a home thinking about the possibility and future of caregiving as being an only child. I also think about the importance of starting to create some type of nest egg that's outside of traditional retirements and other accounts, but also looking at lower energy opportunities to make money, so that there can be that flexibility, so that if someone does have a need and they're far away, you can hop on a plane or something like that, and it's not well, where's that money coming from? Maybe it's money indeed, it's points from a points gal, right? But you know, like, how about how do you get your way way somewhere, but just having that that stash for yourself and for those around you, so a lot of the work that I do is not only that mindset and that mindset and work, but helping people understand what their steps are to take action, so that when people act with that authority, that their their brain and their mindset says that my I'm okay finding. Eventually, that I'm doing the best that I can, I'm growing, that I'm getting to where I want to be, that I have financial goals that I'm growing in, and that even if I, if I'm still a little stuck here or there, I'm just putting down that next puzzle piece, and I'll keep mixing it up and shipping, shaking around, and and turning it until I get to the spot I need to be,

Zack Demopoulos:

yeah, and I've been enjoying your LinkedIn posts, and I, we're going to encourage everybody to connect with Dr. Bellino on LinkedIn, and we'll put that link in the show notes, because we know some of you right now are working out or jogging, so we're not going to have you do that, but we'll put the link in the post, but I love, I love, I think it was, yeah, you did it today, and you talked about don't ask people like, where are you going? I'm sorry, where's your money going? Ask where you're going there, or what do you, why are you building this for this? Financial literacies is something that could be perceived as a great benefit to support caregivers, right, so just here's a question for you: with based on your services that you're providing with your company, if you had a room full of caregivers, right now, students, what would be the best piece of advice you'd be giving them, or question you should give them as far as their caregiver journey that they're about to get on, or they're on?

Billina Shaw:

Identify your why and your goals, so often financial literacy is so focused on getting out of debt and just making your way to getting over that credit card hurdle, and it's important to not spend excessively and live in a way that I think supports your life within your means, within your means. I feel like can have a pejorative perspective, because it's really what someone values, and you're really I promote spending within your, within your values. I don't necessarily say that there's one way to say get out of debt. I also feel that if someone, say, ends up in debt because of a catastrophic event, and they need to take on some debt for caregiving, why carry the additional shame around money when they're just also the way they're just working on keeping their family member alive, that that that debt has significant value.

Zack Demopoulos:

Yes,

Billina Shaw:

and I don't want people to feel like they're they have all of these these swirling feelings around negativity when sometimes it's it's really if it's truly aligned with their values and their goals and their vision. So the most important thing is understanding your why for your money. So many times we just focus on getting out of debt, but if there's no why, there's no purpose, there's no vision. Then first of all, it will likely not happen, and second of all, just, just to be clear, I mean, when you get out of debt and you have a have no assets, your net worth is 00. is not a very fun number, right? Like, I mean, so you know, I think that it's really important to understand what are you moving towards and why. And so, if it is so that you have that nest egg and support, so that you can be free and move around when you're able to provide that caregiving, that's the liberty of the life that you're living for in the future, and then that's what motivates you to save. Also, the fact that if someone doesn't have that now, it's not too late to change, and that there isn't a good or a bad with money. I think of a client that I helped who was in a significant growth process, and actually didn't have the money to bury a family member. First of all, the fact that they felt like that was their responsibility, their sole responsibility, is a whole nother thing. We just basically talked about that, but didn't have the money to bury that family member, and because they didn't, and they had debt at that time, they had, they after that moment, they made a significant shift and change in their finances, but because of that one moment in their time, in their history, in their life, they still felt that they were bagged with money, even when they actually had the emergency fund, they had all of the things that they needed, but they still were just stuck in that past, and so the work that I do helps people to grow and to move towards understanding their goals, creating the vision, moving towards it, but also getting rid of those past hurdles, because care for giving is enough, living in this world is hard enough, as opposed to carrying all of these other burdens with

Unknown:

us.

Zack Demopoulos:

Thank you so much.

Selma Archer:

Yes, in addition to all of these wonderful financial insights that you've shared, you know, because Rosalynn Carter has told us that everybody is going to be impacted by caregiving in some form or fashion. Going to be one, you got just been one, you are going to need one. What would you say to our audience, in addition to all of the financial wellness tips that you've shared with us to walk away with from this conversation today? One or two things.

Billina Shaw:

The first thing is, caring for yourself is not, is not negotiable. It may shift in different times and seasons, and it might, in the way it happens, or the amount of time it happens, may be different, but still prioritizing it in some way, shape, or form is just so important, because not only does it help you in that caregiving journey, but for some people they just might need to realize and remember that it could help them from being that that one that needs the care.

Selma Archer:

Yeah,

Billina Shaw:

I've talked to so many women in the last couple of months who have said my husband has had a stroke in the last three four months, I've actually, my husband has had a stroke, just thinking about how we can actually make sure that we are not the one needing the care, we're in that, we have to invest in ourselves, and I think that's the, that's really the first thing, and that also going through a period of healing and growth doesn't mean that you are not strong just because you take that time away doesn't doesn't take anything away from who you are as a person doesn't take anything away away from who your identity is in that role that's felt that causes you to feel led to care give, but that you're still strong when you take that pause.

Selma Archer:

Great,

Zack Demopoulos:

so many mic drops I can't keep up with, though. I mean, but no shame in debt. What you said earlier, I don't think anyone has ever said that on our show, and that makes so much sense when it comes to being a caregiver. Of course, caring for yourself is non-negotiable. We have heard that before, but for some reason, coming from you, I'm listening. I

Unknown:

was like,

Zack Demopoulos:

I'm listening. Thank you so much. You've been just really amazing, and you've also put brought a whole new meaning to spaghetti dinners, which I absolutely just love that story. I really do. How can people find out more about you and connect with you and learn more about your services?

Billina Shaw:

Sure. Well, the easiest way is you just text grow, like they freely flourish. Grow, I just talked a lot about growth to 5544 that's grow to 5544 and you can follow along with, you can, I can, you can join my emails and text, and we can grow together. And then also, you know, like you mentioned, I have a LinkedIn, I'm pretty active on there, as well as some other socials, not quite as active on those, I'm getting there, but Freely Freely Flourish financial.com is my website as well.

Selma Archer:

Great. Well, thank you so very much. You have helped me to open my eyes myself, especially with that self care. I've been struggling with that lately, so non-negotiable.

Billina Shaw:

Oh my god,

Selma Archer:

I know what that means. Non-negotiable. So,

Billina Shaw:

I would suggest that for everyone, identify that one item that they want to think about incorporating into their life around self-care. Identify that one item, text a friend, and say, 'I'm doing it, and text a friend for some accountability.

Selma Archer:

Awesome. Thank you. Thank you so much for being with us, and for sharing.

Zack Demopoulos:

Thank you, so much, guys. Lena, thank you,

Unknown:

thank you. For tuning in. Be sure to catch new episodes of Working Caregivers, the Invisible Employees Podcast, every other Tuesday. Please also visit our website, Invisible Employee advocates.com to subscribe to our newsletter, purchase our book, and learn more about how we can help you strengthen your workplace to become more supportive of working caregivers, you.