you couldnt have stopped her from doing so if she insisted. But there were a number of red flags that indicated she wouldnt be able to get the care she needed at home like her daughters pregnancy and her sons alcoholism. Now Mrs. Snyder will have to be moved yet again to hospice care and as a case manager its important to limit the number of times a patient is moved. Transitions are stressful and expensive especially for patients who are terminally ill.