In the opening of the book, we are introduced to house 4801, where the 18-year-old grandson, Tyler, indulges in smoking and drinking at a card table in the main room. His 15-year-old sister, Emma, sits alone in the room when an instinct drives Emma to rush down a narrow hallway and into a small room. Here, her gaze falls upon soiled sheets on the bed, and her grandmother, frail and non-ambulatory, lying in distress.

The family encounters twists and turns as Tyler is charged with elder abuse, Emma is temporarily detained in juvenile custody, and their grandmother is placed in the 'Home for the Aged.'