Ellen pieces together the mystery of her grandmother's relationship to Rudolph and Ellis and discovers that she has been paying the men to report on Ellen's and her father's lives. Ellen learns that eventually, Ellis had died and left Rudolph to do the job on his own. Rudolph inaccurately tells Ellen's grandmother that Ellen has been running wild and misbehaving, as he reports only rumors he overhears from the old men and housewives who gossip and speculate. This discovery explains why Rudolph and Ellis had left envelopes of money for Ellen and her father, as they were being paid by Ellen's grandmother to deliver it.
In time, her grandmother's condition worsens, and Ellen is left to care for her. Despite her grandmother's cruelty, Ellen vows not to let her die, for she does not want the responsibility of yet another death. With her grandmother's illness, the source of power and control has shifted to Ellen, as she alone is what keeps her grandmother alive.
Ellen asks her grandmother why she is so cruel to her, and why she does not see that she is not like him. Her grandmother answers that in Ellen's face, especially in her eyes, she can see her father and everything he has done to her daughter. But Ellen cannot understand this and pleads with her, urging that she has done nothing. Immediately afterwards, she wonders why she even dared to ask her grandmother that, as she knows it is not what she has done to her, but what she has not done for her. Her grandmother is infuriated by Ellen's questioning and essentially accuses Ellen of killing her own mother, having left her to die. She vows that Ellen will pay for this until her dying day, and it is in that moment that Ellen decides to spend the rest of her life making up for it, though she is not sure of exactly what it is for which she seeks redemption.
Ellen wonders then if her grandmother has ever been to the ocean but knows almost instantly that she has not, for if she ever stood near something as strong and powerful, surely she would not be so overconfident and cruel. Ellen's next thought is that now would be a perfect time for her grandmother to die.
Eventually, Ellen's grandmother dies. Ellen tries to revive her with her own breath but to no avail. She thinks how her grandmother's usually hideous face is now pleasant to trick Jesus and that the "score" is now two to one; while Ellen must worry over her mother's soul, her grandmother must worry over her own as well as Ellen's father's. Ellen hopes that her grandmother is the last dead person she will know "for a while."
The most pressing question that arises in Chapter 11 is why Ellen chooses to comfort and care for her dying grandmother, who has treated her with nothing but extreme neglect and cruelty since her arrival and continues to even while Ellen coaxes her through illness. Why, we wonder, is Ellen so willing and motivated to nurse her grandmother with such care and tenderness? Similarly, in Chapter 5, we may wonder why Ellen felt compelled to buy and wrap Christmas gifts for her abusive father. Ellen's generosity and kindness is not derived from a feeling of love for her grandmother or her father, in Chapter 5, but instead a compulsive and precocious sense of responsibility. Ellen seems an eleven-year-old adult, accepting and performing duties that seem far beyond her years, such as when she must pay the bills and grocery shop for herself and her drunkard father.
Ellen cares for her grandmother so earnestly for two crucial reasons. The first is that Ellen is petrified of death, as she has experienced so much of it in such a short time, first with her mother's death and shortly thereafter, her father's. Ellen is so ridden with guilt for allowing her mother to die, especially while she was with her, that she resolves not to let it happen again, this time to her grandmother. This feeling of guilt is both planted and exacerbated by her grandmother, in her constant reminders that Ellen must take better care of her than she did her mother and also by her comments that Ellen bears a striking resemblance to her father, who is truly guilty for her mother's death. With her grandmother's insistence, Ellen comes to believe that she, in a sense, murdered her own mother and is confident that she is to blame, although her mother killed herself by overdosing on her medication. Ellen does not want to take the blame for her grandmother's death, as well, and is determined to avoid feeling more guilt upon her inevitable death.
The other significant reason that Ellen cares for her grandmother is that it gives her a newfound sense of control. When her grandmother falls ill, Ellen must suddenly assume a position of power. At eleven years old, Ellen is the household matriarch and essentially controls whether her grandmother lives or dies. One might say, even, that Ellen "plays God" to her grandmother; she asks herself if she should "let her die tonight," knowing that she has the power and control to decide. To assume the role of the household leader is not an unfamiliar position for Ellen, as before, when living with her father, she was forced to do the same. Ellen's relationship with her grandmother, however, is very different from the relationship she has with her father, especially now, as her grandmother is physically weak and essentially powerless. By contrast, Ellen's father was physically capable and used his strength as a force to lord over his defenseless daughter.
There is yet another symbolic reference to nature in Chapter 11, this time, to the ocean. There is much natural imagery and symbolism throughout the novel, though water is the most prevalent. Just before her mother's death, Ellen feels as though a "storm is coming." And, during her mother's funeral when the "storm" has come, there is a rainstorm, and Ellen wishes that her father will be struck by lightening and die. Nature, logically, is regarded as a force greater than oneself, and Ellen employs this idea once more when, for a moment, she wonders if her grandmother has been to the ocean. She knows, almost automatically, that she has not because if her grandmother had stood within such close proximity to a force so much stronger than herself, she would understand her own relative smallness, as Ellen does.