What about you? Caregiver burnout | Dr Ginni Mansberg | Club Sandwich
If you’re caring for ageing parents and quietly thinking “I cannot keep going like this”, you’re not imagining it. Sometimes burnout is not a mindset. It’s your body calling in the debt.
Ageing Parents? You've got them, we've got you.
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In this episode:
The Conversation: Sarah Macdonald and Dr Ginni Mansberg (GP and women’s health advocate) get brutally practical about what “real self-care” looks like in the sandwich years, and why midlife bodies hit a tipping point.
🔧 This Week's Hack: The minimum viable self-care reset:
1) Book a GP check-up and rule out the basics (iron, thyroid, sleep apnea, anything fixable).
2) Reset your sleep expectations and take snoring seriously (it can be a health issue, not just annoying).
3) Build one steady routine and a doable nutrition baseline (protein, fibre, calcium) without becoming a full-time meal-prep influencer.
💌 Listener Letter: Sharon asks how to spot burnout when her body has started rebelling after years of 10-hour days and caring for everyone else.
🔥 Hot Mess Moment: Sleep in your 50s, teeth grinding, snoring orchestras, and the myth that “good sleep” means eight perfect uninterrupted hours.
Meet the regular Clubbers:
Melissa Reader - CEO of Vera and expert on Australia's ageing crisis.
Jo Lamble - Clinical psychologist specializing in guilt and family dynamics.
Dr. Ginni Mansberg - GP and women's health advocate who tells it straight.
Dr. Stephanie Ward - Geriatrician helping you understand how we age.
Kerry Milligan - Gogglebox star bringing humour and honesty to the sandwich generation.
Topics covered in this episode:
- Carer burnout and the “body tantrum” warning signs
- Menopause, inflammation, and why midlife health can suddenly slide
- Cortisol myths, chronic stress, and what burnout can look like physically
- Sleep in your 50s: what’s normal, what’s not, and when to investigate sleep apnea
- Hypervigilance and insomnia (and why your brain won’t switch off at 3am)
- Real self-care basics: check-ups, routines, food, movement, and asking for medical help
- Brain health: routine plus novelty (learning new things without blowing up your life)
- A gentle nudge to rethink alcohol as “the only off switch”
Episode sponsor:
Altina Drinks - non-alcoholic craft wines for the end-of-day ritual. 15% off with code CLUBSANDWICH at altinadrinks.com
Credits
Club Sandwich is brought to you by Vera, helping families caring for ageing parents navigate this stage of life, so you don't have to do it alone.
Sarah Macdonald - Host + Executive Producer
Melissa Reader - Commissioning Editor, Executive Producer + Clubber
Rachel Fountain - Executive Producer
Audio + video edits by Fountain Media Group
Thanks and kudos to Sean Wayland for our awesome theme music Club Sandwich - hear more from Sean at seanwayland.com
See omnystudio.com/listener for privacy information.
Transcript
Club Sandwich is recorded on Gadigal land, home of the EORA Nation. We pay our respects to elders past and present. Always was, always will be.
Hello, welcome to Club Sandwich. My name is Sarah McDonald and this club is for you. If you used to go dancing until you fell over, but now you're more likely to be possibly with your parent in Emerg because they've had a little bit of a fall, this is for you. If you squish between a lot of layers of life, we're gonna try and help you with some help, some hacks and some ways to navigate all these layers of life. Now today I wanna talk about you. Yes, you. I wanna find out how you are going. And to help us is Dr. Ginny Mansberg. Now Ginny is a doctor who has a practice where she only sees one women of a certain age. Middle aged women who are in the sandwich generation. So Ginny, welcome. How squished is your sandwich and how crowded is your dance floor?
Oh, pretty crowded. So I was like going me, me, me as you were talking. So yeah, I'm 57, my mum is 85, I've got kids who are 33, down to 21. I have one granddaughter and my second son's wife is 39 and a half weeks pregnant. As we're recording this so probably it goes to air. I'm gonna be a grandmother of two. It's working.
It's a four layer sandwich and working, working full time.
Yeah, yep, yep. So yeah, all of the above.
Tick, tick, tick.
Cleaning a house, cooking the dinners, whatever.
Yeah. Doing a skincare range and having a medical practice where you see a lot of women at this stage in their life. Yeah.
I am lucky enough that I sort of landed on my feet having a practice dedicated to midlife women which is just like the biggest, best thing ever. I love midlife women, I love Gen Xerman. They're the best.
We are the best. Why are we so good?
I think possibly because we grew up being chucked out the back lane with a bike and no one was really too worried until we sort of, it was maybe 10 o' clock at night and we hadn't come home but like we were quite self sufficient and we were also in that generation that were told we could literally do everything, like we could do it all and we didn't feel, feel hemmed in, I don't think by being a woman or I certainly didn't.
Well, I think we're feeling a little bit hemmed in now. Yeah. So I want to come to some of that but perhaps we should start about the joys of this time of life. Because there is a freedom, I think, that comes with this time of life and a power and a bit of a glory and a bit of an up yours to a lot of things.
Yes, yes, yes to all of the above. So I feel really bad telling you this, but the best of all the goods is the kids moving out. I'm so sorry, Sarah. It's. When my last one left, I was like, bye, see ya. Don't let the door hit you on the way out. Cleaned out that last room because it was disgusting and I was just so happy. It was like the best day of my life. And then now I have grandchildren which are amazing because you get that gorgeous baby smell and they look at you and they goo and then you go, I'd like to have a full night's sleep. So here you go, see you later. Have that one back. You get to completely ignore all of the gentle parenting that's being proffered onto you. Just great. I'm not doing that. And so there is. And there's a bit of financial freedom, I think that does come other than the Gen X's who feel really guilty because our Gen Z kids can't afford a house. And so we feel like we're going to need to put our retirement on hold to fund them into.
Yeah, well, they can't afford to move out and if they ever are going to stay in the same city as you, you're going to have to help them. So we can't really retire.
Yeah, no, you can'. Retire. Yeah, let's just work forever.
Yeah, exactly. Well, what we're going to do every week is have a bit of a question from a clubber. So this is a clubber in her late 50s, let's call her Sharon. And she says this year my body had a bit of a tantrum. After years of working 10 hour days and juggling care for my mom and kids, it rebelled. I've had some autoimmune issues, I've had shingles and I've been exhausted in ways I didn't know possible. I felt like I've worked more than 50 years abusing my body and now I need to look after it, but I don't have time. How do you know you're heading for burnout and what can you do to prevent it before you toast?
Yeah. So Sharon, there's a bit to unpack there. How old is Sharon again?
Late 50s.
Late 50s. Okay, so I'm just going to assume that Menopause is well and truly in the rearview mirror because the average age for Australian women is 51. So one of the things that oestrogen does is it's anti inflammatory, which is so good on so many levels. But once you go into menopause it's like all of the would be, you know, inflammatory warriors in your body are let off the leash. And so, hello, you get a whole lot of autoimmune stuff happening around that 50 year old mark as you go into menopause. So I'm wondering, Sharon, if that's partly what's going on for you. Plus you're a bit older now, you know, all of those years of abuse, it's not like you, you pay on day one. Well, after a cheeky body too many, you might pay on day one, but mostly it's accumulated.
Yeah, now pay later.
And you've got a sleep bank. We now know this from research and so build up enough years without sleep, without decent amount of sleep and it eventually sort of calls in, you know, the chits. It's kind of says, you know what, you're going to have to, to pay up, otherwise I'm going to give you some exhaustion. And I do wonder for Sharon, like if she's not looking after herself. And this is just what I see on a daily basis with the women that I see. They don't eat well, they don't take time to exercise because it feels a bit self indulgent to go to a gym or to go for a walk when you should be. Well, there's your list. You can feel like it's all too hard to chop those vegetables and make that salad. It's just easier to get a bit of Uber Eats. I really get that. And I don't want to sound like I'm finger wagging because I'm not. I really, really get it. But women do put themselves last. And as a result, if you've gained weight, if you've ended up with sleep apnea, which is a condition in which your snoring is more than just annoying your partner, it's actually damaging your health and causing you to wake up tired and unrefreshed and then continue that way for the rest of the day, these things can take a toll. And we do need to maybe check in with the gp.
Yeah, I want to talk about sleep in just a moment, but the cortisol and the burnout thing's an interesting one. Like, so you said we've got a sleep bank. Do we have a cortisol bank? That just basically gets so full that it can kind of lead to collapse in your 50s, especially when you've just got layers of care like sandwich generation. People often do.
So I measure a lot of cortisol levels and it's quite rare that I find one that is disordered. I'm not going to lie. Even though we talk, there's a lot of cortisol in the zeitgeist. I think the science is running a little bit behind that. So in a stressed situation, it's really important that, particularly if there's an earthquake and you need to run away from burning buildings, for example, that you have enough sugar in your bloodstream, that there's enough blood supply to your legs that you can run really quickly and your tunnel vision gets really, really good. And so your body has a system for enabling you to outrun danger. So things like long term memories, immune system don't really matter as much as just that moment of getting out of danger. So that job is initially given to adrenaline from one part of your adrenal glands. It can't really sustain that for more than 24 hours. So it's really good. If you just quickly, narrowly avert driving into another car, for example, your adrenaline will give you a big, big crash in and you'll get your heart rate going up. You can really feel it. Right? After a while, your adrenal glands go, gonna have to give this job to a long term actor. And that's where your cortisol steps in. So it's not for acute stress, it's for long term stress where your adrenal glands can't take it anymore. We're kind of talking 24 to 48 hours. And the impact of your adrenal glands secreting cortisol is not just that you are kind of ready for a physical stress that often doesn't come, but it puts some things on the back burner. Memory is a big one. So a lot of people just feel like my memory is not working properly. I think I've got dementia. That's probably your cortisol. Your immune system does not work as well. Your skin thins, you can actually gain weight, you can actually feel depressed if the cortisol is there for long enough. But is the high cortisol level really responsible for all of burnout? If you take blood tests, the answer would probably be no. But is burnout a thing yet? It absolutely is a thing, even though it doesn't fit in with a traditional medical diagnosis with, you know, diagnosable categories around it.
So it's mental and physical and possibly spiritual. Like that constant care for someone else and not caring for yourself.
I think it's that bit, the not caring for yourself because I think women are natural carers and I think we're really good at it and I think we derive a lot of joy and satisfaction. Maybe joy is not the wrong right word, but it definitely makes you satisfied to care for other people. Women go into caring professions and no one is telling you not to do that. But it's where that caring makes you unable to care for yourself that we then, Houston have a problem.
Yeah. That overload. And you know, hashtag, I know a lot of blokes doing this too. Right. But they don't seem to get as emotionally wrought. I think they're able to disconnect sometimes and I want to do an episode on guilt down the line. But I mean, what about when there's that sort of they're managing everybody else's medical appointments, possibly not coming to see you and other doctors themselves. That sort of constant. I'll deal with that later. I'll get to that later. I've just got to focus on mum right now or my dad right now or my child right now or something like that. So there's often that put off, isn't there, for your own kind of health and well being.
Yeah. And a lot of women that I see feel that to pay attention to their own well being is a little bit self indulgent.
Yeah.
Like just a little bit pretentious. Like the real stuff is caring for everyone else. But if you care for yourself, that's just a bit wanky and you should be a little bit ashamed of that. And there's a lot of shame and self loathing wrapped up in the idea that you deserve to be well as well. And yet, you know, the reason why the airplane, say put on your own mask first and then put the mask on others is because you won't be a very good ringmaster of the circus you're running if you're falling apart. Like the best job that you can do for your kids is actually to look after yourself. But women feel incredibly self indulgent from doing that.
Well, I think, you know, you think if the plan's going down, what point's putting oxygen mask on? It's going down. We're all burning down here. It's interesting that whole self care, you know, hashtag, have a nice candle, have a nice bath, when really it kind of can often feel like the whole capitalist system and the system having to do the care for others is really against you in the first place. So I get that. Or. But that's that do I not deserve this? You kind of don't want to have those try little things in your head, do you think?
I mean, I really think that it's Gen X women, our mothers and our societies kind of valorize the giving woman, like the woman who puts everybody else's needs first. The Mother Teresa types who just were giving and giving and giving and giving and they were. The eulogies for women like that are extraordinary. But that's really the value, the feminine value that's ascribed to a really great woman. And self care is not really part of that. And men are not given those same cultural norms around self care. It's totally fine to have a need and to express that need for women. That's a little frowned on.
I think we should maybe redefine self care, shouldn't we?
Yeah.
Like what is it really? Eating well and getting some exercise yourself.
Yeah. And if you see, go and see a doctor, like if you don't feel well, it's actually okay to go and see a doctor and actually get some help for yourself.
Take your dad's appointment. Yeah, totally. I'm turning up in his place. You mentioned sleep, Ginny. This is a really interesting one. I actually woke up for the first time a week or two ago and I thought something's different. And I realized I didn't have a sore jaw, I wasn't grinding my teeth. Years of grinding my teeth, I think from stress.
Did you put a splint on?
No, I haven't had a splint but I've done sort of, you know, it's gone on and off over years and it sort of harps up when things are really falling apart and then it goes down again. But I think I did had been doing it again and I hadn't even realized surreptitiously. Sleep is a massive one, isn't it? You know, like I ground my teeth on the dance floors in the 20s. I don't want to do it again now in my 50s. But it's easy to say get more sleep.
Yeah. And I think we need to maybe bust some myths about what is normal sleep and what you should be expecting at our age. So here's what normal sleep is not. It's not going to bed at 10 o' clock and then waking up at 6 o' clock the next morning feeling completely refreshed and having not had a trip to the toilet and not having had a moment of wakefulness at all and that you put your head on the pillow and fall asleep within 10 minutes and then wake up feeling ready to go for the day. That's fantasy land. That does not happen to women in their 50s. And that's okay. You can still have a perfectly normal sleep, having one or even two trips to the loo. And even if it takes you 10 minutes to fall back asleep, when you go back to the toilet, it's around total hours of sleep that you've had that you've roughly followed. You know, you've had a bit of deep sleep, you've had a bit of REM sleep, a bit of non REM sleep, that you've managed to hit all of those milestones and you're not having less than five and a half hours. That's really where it starts to get a bit tricky for your brain.
And hello, if you are listening to us in the middle of the night after having gone to the Luang car, get back to sleep.
It's not the end of the world. And if you wake up for the first half hour, you still feel groggy, that's okay too. It's okay for the springs out of bed. I know, but I think there are people who are so stressed about their sleep not being what influences tell you your sleep should be, that the lack of sleep that they think they're having is actually causing them like, stress and adding to their mental load. Okay, can we just take that off the table? Like, we don't need to do that much worry about it. Having settled a witch for that subset of women who. Who don't sleep more than five hours a night regularly, who wake up unrefreshed and remain unrefreshed. If you wake up with a headache, which is very likely from clenching or grinding your teeth, it's very likely if you have got sleep apnea, if you wake up with a sore throat, those sorts of things. I am a little bit concerned for you. And actually we do need to get it sorted, particularly if your partner goes, oh my goodness, the orchestra was playing pretty loudly last night. It was like if you were snoring really loudly. And it's so funny. Ask every woman what her male partner's sleep is like. They can tell you in detail. Ask a male what his wife's sleep is like. They go, I don't think it's okay
until she starts joining the snoring chorus that's going on in the bedroom. Even then sometimes don't. The blokes don't start the snoring first. Yes.
I think we should be like championing more sleep divorce for couples where the man is like not happy to go to the doctor and get him his sleep apnea sorted but like expects her to sleep in the bed with him and snore like a drain. No, no, you're getting, you're going to sleep in the kids ex bedroom now they've moved out.
Those sleep apnea things are very different now. It's not like Darth Vader anymore. I went to yoga camp recently with a friend. She had one. It's this tiny little thing. Fruit change, little mask.
They say that for older women it's as common as it is for older men. It's just not diagnosed in women because people think women don't snore. Yes, we do.
Especially after a glass of red wine. Oh yes, and a bit of. And a bit of cheese. This week's sponsor is Altina Drinks and this feels super relevant for me right now because I've actually been trying to cut back on alcohol. I went to India, I went cold turkey. I'm just trying to have a glass or two of wine a week now. Altina Drinks is for you. If you're really trying to cut back on alcohol or give up and you just need that ritual at the end of the day or at a celebration or somewhere in your life that is tasty with complex flavours and non alcoholic you can go to altina.com and if you put in the Code Club sandwich you get 15% off your order. So check it out. Hello clubbers, do you want to hang out in real life? We are doing a bit of a roadshow. This is connected with a film called Careless by Sue Thompson. She'll come along, we'll talk about the film and getting her mum into care and the help she needed along the way and the difficulties of the whole conundrum that's at the heart of this. Other clubbers will be there in the room too. Going to five cities. We're going to Brisbane, Sydney, Melbourne and Canberra and Hobart. We'd love to see you in real life. The tickets are free, you can have a look in the show notes or go to clubsandwich.community or humanitix and come along, we'd love to see you share some bubbles of the alcoholic and non alcoholic variety and be in the room for club sandwich. I think the hyper vigilance an interesting one too, isn't it though that there's so much hyper vigilance that can affect your sleep that that brain Churn goes on. I've got to do this tomorrow. Oh, I've got to, you know, help my son pay some of his hecs debt. I've got to, you know, take my mum to the doctor. I've got to do this. That you're constant hypervigilance about how people are around you.
Yeah. It's actually interesting research about that because I think we always assumed that your busy mind stopped you from sleeping. And now we kind of know that if you are an insomniac that what will fill that void is actually all the things that you need to do. But it probably is not the cause but the result of the insomnia, which is interesting. So in other words, if you're not sleeping because you've got insomnia, because your brain is just not letting you go to sleep, then you'll start thinking about things. But the thinking about things doesn't actually stop you from going to sleep. If you're tired enough, you will go to. Your brain will override that thinking and go to sleep. So there are heaps of people who have lots and lots and lots to do and lots in their brain and they still sleep fine.
Well, you have those thinking dreams where you're not dreaming of wild fantasies, you're dreaming of what you have to do. And it's sort of those sort of, you know, to do list dreams. But at least you're asleep, I guess.
Trade one one of those for a sexy dream any day. That's very boring.
I have them all the time. That's the whole thing.
Confession. Sarah. I love it. This is so great. You don't have hypoactive sexual desire disorder. That's for another day on the podcast.
Oh, okay. We'll do that another time. That's so interesting. What about the kind of basics of real self care? You mentioned that like what do you is the medical advice you think you'd give to all women who are in the sandwich generation or blokes really as well. I'd love them to be listening too. About this time of life, when you're feeling that squish, those layers of care that need to just sort of do the basics for yourself, what do the clubbers need to know about those basics?
So get off social media and the people who are trying to sell you a solution in a jar. There is no vitamin supplement, there is no protein powder, there is no candle or weighted blanket that's gonna make you not in the sandwich generation. This is your reality for now. So there's gotta be a level of acceptance to what is happening right now. And in the same way that you can't tell somebody with a huge mortgage that they should just quit their job. It's like, yes, I guess they could go and live in an ashram somewhere in India, but in the real world, they have to stay in their job. So how are we gonna solve for the issue that we have right now in terms of what will actually work to make you feel more energetic? First stop is a trip to the doctor. Cause there's no point in doing all of the amazing lifestyle stuff and then finding out you got a thyroid disorder or an iron deficiency, which is common in women who've had heavy menstrual bleeding towards the end of their perimenopause period. Like, and then they never got it fixed. So let's get the blood test, get the basics fixed, talk about your snoring, find out if you've got sleep apnea. Let's just rule all of that stuff out because that's kind of your low hanging fruit. We can fix that.
Check up, check up.
Great idea. The next thing to do is to look at your lifestyle. And as much as I would love to be able to promise you that you can live on pizza and Tim Tams and then undo it all with a vitamin C capsule, we cannot. So we are going to need to invest a little bit in what you eat, how much you exercise, these really basic things, the circadian rhythm. And by that I mean not just going to bed at the same time each day, but actually having a shower roughly at the same time every day, eating your meals at the same time every day, having your exercise roughly at the same time. Routines are so good for you. I mean, that's why I advocate staying in work as long as possible. Apart from the fact that you gotta pay off your kid's mortgage, but it's also because it keeps you in a circadian routine. The worst thing you could do is go and retire to Queensland and sit on a beach all day.
Really?
Absolutely. That's terrible for your brain. That's how to have the highway to dementia. If we want to keep you younger and more live and young for longer, we will need to keep you in a routine. Keep your circadian rhythms going, keep your gut health good, keep your diet good. That does not mean that all of a sudden you're going to give up work and go into chopping vegetables and making a chicken ragu for dinner every night if you can. Fabulous. Well done you. Your medal is coming in the mail. But for everyone else, I would stick stuff into ChatGPT. I love ChatGPT. It's just so good. So just put in your nutritional requirements. So about one gram of protein per kilogram of body weight that you have right now per day, about 30 grams of fiber, and about, for women our age, about 1300 milligrams of calcium. That's going to keep your bones nice and strong. So let's do that. Put all of your food foibles, all of the things that you hate, put all of your restrictions, and no, I can't do this, and no, I can't do that. Put it all into ChatGPT and get out to spit out a diet plan for you that you can actually follow and tell it. I'm gonna need Uber Eats three times a week. This is my address. What delivers that is healthy, that's gonna meet this criteria. But that's okay. But I think we just need to get real about not saying I just can't eat healthily, but yes, you can. You're gonna have to.
Yeah, I think it's the last thing on my list of care because I've started doing the weights. But here's the thing you mentioned. Routine is really important in keeping your brain active. But I thought routine was not good for brain thinking. Like, you've got to kind of also learn new things. And that's, that's an important part of work too, that you've got to still be learning. But sometimes if your job's kind of the last thing on your list, just like, I just want to keep that easy.
But if we can keep the circadian rhythm the same. But if what we can do is have your neuroplasticity, which is creating more what we call neuro circuits. So a highway from this part of the brain to that part of the brain to connect a new idea. We want to be growing those all the time. But what if you said Monday evenings between 7pm and 8pm I'm either I'm going to do a new language or I'm going to listen to cryptic poetry, or I'm going to join a hang gliding club or whatever it is that you do something different every Monday? It's still part of your circadian rhythms that are regular. But at least now we're going to do something completely different. But why don't you go a different route to work if you always catch the bus, catch the train, catch a different bus.
Wow. Okay. She didn't say lie in bed and drink wine and watch Netflix. Unfortunately, there are days where you need
to do that Sarah. Come on.
Hashtag self care. Yes.
Love that.
Cryptic poetry is the next. That's the name of my new punk band. That's a good one too. I'm gonna leave you with this question. What are you gonna do for yourself this week? As perhaps step one of looking after yourself with actual real self care? Not the kind of candle variety. Ginny. What about for you?
Seriously? I'm getting on a plane to New York in day and a half and I'm gonna go visit my granddaughter, slash granddaughters. Cause there will be two of them and I'm gonna give them a great big cuddle and tell the parents to nick off and I'll have the grandbabies on my own for a little while and that will be my self care.
Well, I was thinking I'm going to take a friend who's not well for a swim. And then I thought, is that doing something for me? You're going to care for grandchildren? I'm going to care for a friend. Look at us, magna doodle, doing something for ourselves.
I'm going to read a book because I'm halfway through tomorrow and tomorrow and tomorrow and it's not like I. I don't love that book.
I love that book.
I just haven't had time to sort of finish it. So on the plane, watch me go halfway to the end.
Read a book. Okay, I'm just some wild dancing in the kitchen. How about that?
Love that.
That'd be fun. Please forward this to a friend or someone you know who is running on empty and going through this. Perhaps they're not looking after themselves. Perhaps they need these wise words in their ears. Please send us a review and your questions as well. We'd love to have your input into the episodes of the podcast as we go forward. And remember, we know it feels like you're doing this alone, but you've got them and we've got you.
Doctor Ginny's just been talking about burnout cortisol and how, yeah, us women, we all always put ourselves last. If you're running on empty and you're trying to manage everyone else's medical appointments before your own, please take a pause and have a chat with Vera. This is a free 15 minute AI voice conversation for those of us who are looking after ageing parents. It looks at your parents health and independence and it checks in on you too. Vera will give you a personalised guide that looks at your situation, reflects what's actually going on and starts to give you some clear next steps. What to stabilise who to connect with and what to plan for next. Because you can't keep putting everyone else's oxygen mask on first, you can find Vera75 in the show notes or visit Vera Guide.