During the weeks before her death, Anna completed describing in detail memories of School of the Arts, Cedarcroft and Rumson. Warned by her aunt G (father's side) that she would make her own child sick if she said negative things about "the family", she described what was positive, but always insisted on stating the whole of what she knew to be true. She asked for assurance that her book would be completed, saying to her mother"s partner Gary, "You'll see my mom finishes the book won't you?" She expressed fear of remembering additional sexual abuse by persons she trusted, saying she could not stand for such memories to be true. She filled a paper tablecloth covering a picnic table in the ward courtyard with graphic drawings of figures engaged in numerous explicit sexual acts. She was increasingly frightened by nightmares of skeletons and death, and distressed by repeated dreams of her family abandoning her. She gave her mother all her artwork to photograph and keep safe. She began to talk with Gary and her mother about her voices, and told her mother she wanted soon to tell her who all the voices were.

On Anna's thirty second birthday, October 20, 1992, her mother and Gary took her present- a stereo radio and tape player she had wanted, dinner, and a birthday cake large enough to share with other patients – to Napa State Hospital. Anna had been granted a four hour visit off grounds with her mother, from 1:00 to 5:00 p.m. Unable to get to the hospital until 3:00 p.m., Anna's mother asked to spend the four hours with Anna at a local park from 3:00 to 7:00. Her newly assigned psychiatrist refused permission. She must be back by 5:00 p.m. Her mother and Gary reasoned with the doctor that Anna could have dinner with them and be back just after the other patients returned form dinner. There were no ward "activities" she would miss. Still her doctor said no, the predetermined schedule for Anna that day must be strictly adhered to. Anna was dismayed, but ther was no other option, and "disobeying" might result in further restriction of Anna's time off grounds.