Lorraine and John tell Mr. Pignati the truth that they aren't the charity workers and that they are high school students. Mr. Pignati then tells them that his wife has passed after they tell him the truth.
Mr. Pignati, Lorraine and John were playing tag on roller skates and John decided to go upstairs to get away from Mr. Pignati. He had decided to follow John up the stairs and Mr. Pignati had put his hand on his chest and he fell down the stairs.
John and Lorraine had lied about being Mr. Pignati's children again so they would be able to visit him in the hospital. The kids only pretended to be his children because the only people who were able to see him were immediate family.