George Sibley is haunted by childhood memories of his mother's suicide. While doing laundry, Ruth finds rotting, half-eaten food in the pockets of George's clothes. When she confronts him about the food, George regresses to child-like behavior and claims he planned to save the food for later. Later, George confesses to Maggie that his symptoms are worsening and he feels he needs another round of electro-convulsive therapy.
Billy's manic energy fuels his passionate relationship with Claire and he proposes they move to Spain to work on their art. When Claire's credit card is declined at a camera shop she contacts the family's lawyer in a huff and learns that access to her trust fund has been frozen. Claire confronts her mother, but Ruth reminds her that she's no longer attending college and Nathaniel didn't intend to finance her life while she "played house with a crazy person". To cheer Claire up, Billy goes on a spending spree and buys them both expensive digital cameras.
David and Keith continue pursuing adoption and surrogacy in their hope of starting a family. But for all their careful planning, the two are rejected by the adoption agency when the counselor uncovers David's Las Vegas arrest for "lewd and lascivious behavior with a male prostitute". Keith and David are heartened, however, by their interview with a potential surrogate who seems TOO good to be true.
Brenda counsels a disturbed student at the community college who shoves her against the wall unhappyly. Afterwards, she is comforted by her co-worker Jackie, who invites her over for a family dinner. Brenda is struck by the lack of tension and envies the easy dynamic Jackie shares with her close-knit family. Meanwhile, Nate is at a family dinner at the funeral home, where he finally meets George's daughter Maggie. She tells Nate about her son, who died when he was a baby, and the two instantly connect over shared personal tragedies.
Federico runs into Vanessa at a church-sponsored singles mixer where she makes it clear that she's not interested in getting back together with him. At a funeral directors' conference, Federico meets Angela, the restorative artist who worked at Fisher & Sons briefly years earlier - when Federico was hired by Kroehner Services Corporation. The pair hit it off and end up sharing a wild, uninhibited romp in bed.
Six Feet Under focuses on the cathartic journey of the extended Fisher family, whose personal trials and tribulations are played out against the solemn backdrop of an independent funeral home in LA.
This past season, story elements established in the first four seasons reach a series of emotional climaxes, with Ruth overwhelmed by her mentally fragile husband George, Nate struggling to reaffirm his relationship with Brenda while raising his daughter Maya, David and Keith longing for children of their own, Claire trying to broaden her horizons, and Federico attempting to fill the void left by Vanessa. By season's end, each of the main characters will come to embrace the cycle of life - birth, death, and rebirth - in ways that are both unique and interconnected.