Kate (Hilary Swank) is a classical pianist that is diagnosed with ALS. Her husband Evan (Josh Duhamel) finds out one morning that his wife had fired her previous caregiver, Mrs Trotter, and that Kate was finding a new replacement. Bec (Emmy Rossum), a wild college student who parties a lot, applies for the job despite her lack of experience apart from having volunteered at a nursing home her grandmother was eventually placed in during her high school years. Kate sees something special in Bec albeit her slightly vulgar language and poor housekeeping skills.
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Yet, despite all the mayhem Bec has caused at home, from messing up the kitchen by blending up a drink without putting the lid on the blender to dropping Kate in the bathroom, Kate maintains a calm and positive demeanor which confuses Bec. One night, Kate has her friends over and finds out that Evan had gone out for drinks instead of dinner unlike what he told her. Later that night, Kate convinces Bec to access Evan's laptop and they find out that Evan had an affair with his secretary, Cynthia. Distraught, Kate tells Bec to leave however Bec comes rushing over to Kate's during a night out in a bar when she gets a call from Kate. Bec finds Kate at the top of the stairs after a failed suicide attempt where Kate had almost let herself fall down a flight of stairs. Kate then requests for Bec to bring her elsewhere and away from home. They end up staying the night. In the morning she tells Bec to take her to an assisted living home, but Bec refuses to leave her there and is furious that Kate blames herself for ruining Evan's life with her ALS. Eventually, Kate splits up with Evan due to his brief affair, as well as her wanting not to be invisible after receiving a brief and angry pep talk by Bec.
Bec and Kate have a couple of adventures, including going to a club, meeting another couple where the wife has ALS and trying "herbal therapy." They eventually go to a party for Kate's friend's daughter. Kate asks to hold the baby, but has a coughing fit and almost drops the baby. While Bec is taking care of Kate inside Evan appears and Kate has Bec tell him that the reason she wanted him to leave was not because of the affair. She was just tired of being invisible. The wife from the couple they met earlier has a complication due to her condition and is hospitalized. It scares Kate when she sees what happens eventually to ALS patients. Bec briefly talks to Kate's "best friends" who tell her to tell Kate that they love her, miss her, and are here for her. Evan visits the house again, but Kate and Bec turn him away again. Bec's parents visit for Christmas and a conversation with her Mom that is heard over the monitor by Kate causes Kate to fire Bec because she believes that her illness is ruining Bec's life like it did with Evan.
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