It becomes known to the main characters that the old woman is dying, also afflicted with the Black Scrawl. She wishes to see her lover one more time, who she has been sending and receiving letters from. When Nier tries to convince the postman to let the old woman leave, he finds out that the letters had been faked by the whole town and that the old woman's lover had died over fifty years ago. He is then given the choice to tell the old woman the truth, or lie.
After going back for a final quest, it is found out that the old woman had finally succumbed to the Black Scrawl, but died with a smile on her face.