The first thing someone who started following the strip right about now would notice is that Elly is sort of desperate for any sign that the people around her appreciate what she does for them and don't simply take what she does (or for that matter, her) for granted. This is a problem because she lives in a world that seems to think that being praised for doing things she's "supposed" to do is bad form and also corrupting of the moral fibre. John and the kids might indeed be glad to have her in their lives and love living in the home she makes for them but they'll be damned if they let her know about it because she might become some sort of egomaniac if she realizes that they really like her. They don't understand that Elly needs to feel good about herself in order to feel as if she's making a difference because their culture won't admit that as a possibility.
This leads us to the central emotional tension of the strip: Elly's desperate quest to find any sort of identity that allows her to finally hear the words "We like you and we appreciate what you do for us" and its collision with imbeciles who can't understand what she's hungry for because they believe that the work itself should provide satisfaction. As she says, they only seem to notice what she does when she's too sick to do it and expect her to work and work and work without any expectation of recognition because she can't read minds.