Dorothy "Dot" Greenbaum and Rafaela "Ralfie" Santopietro have been together for years, but as they age, their stable lives begin to show cracks. Ralfie can't navigate the stairs in their home after a debilitating knee replacement and Dot's heart condition throws into question the viability of their careers, their housing, and their relationship. In their late sixties with no kids to lean on, the two women must come to terms with unforeseen questions of identity, love, and family.

Dot is caring but hides hurtful secrets. Ralfie's gruffness masks the physical and emotional pain she endures. Friends and relatives don't necessarily offer appealing role models for their third act. Dot's sister Susan is pushing them toward a stuffy "55 or better" community out in the 'burbs, populated by aging straights who mistake the butch Ralfie for a frumpy old man. Eighty-year-old Viola-Dot's friend and sometime lover-lives alone and refuses help, even as she experiences a devastating fall. Rife with Hoffman's characteristic wit, Dot & Ralfie takes a hard, sometimes painful look at elder care in the LGBTQ+ community, and the unique struggles that come with getting older outside of heteronormative structures.