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.