Larina's daughters Katie and Kari are overwhelmed by the extent of their mother's hoarding. Katie, in particular, is devastated by the thought of her younger sister Alexiah living in those conditions.
With the help of Dr. Julie Pike, Donna comes to realize that her dependence on puppets is a deflective mechanism to avoid distress and negative feelings.
Renee's sister comes to the house for the first time to see for herself -- and it's far worse than she could have imagined. The challenge is being supportive, while being honest.