Before you grab the Red Jeweled Brooch off the rooftop in Tomb of Oedon you should decide which path you want to take with Viola’s Daughter (see the section below). You can now open the gate at the top of the steps and follow the path to a library with a note and the Blood Gem Workshop Tool before continuing to Cathedral Ward’s chapel.
Speak with the Oedon Chapel Dweller to learn that you can send people to this location for safety and then light the lamp to return to the 1st Floor Sickroom.
1st Floor Sickroom
Head up the stairs to speak to Iosefka to learn that you can also send people to her location and then make your way to Central Yharnam on foot or via Hunter’s Dream.
Start by talking to Gilbert at the window of the building next to the lamp for the Flamesprayer and then head through the shortcut, through the dark house to the caged Rabid Dogs, and speak to the Lonely Old Dear in the house across the bridge.
You can now choose to send her to either Iosefka’s Clinic or the Oedon Chapel. If you send her to Oedon Chapel you can visit her later for items and if you send her to Iosefka’s Clinic she will be unavailable later, but Iosefka will give you a reward if you return to the 1st Floor Sickroom door.
Make your way back to the lamp and warp to the Tomb of Oedon and re-enter Central Yharnam. Take the stairs down from the Tomb of Oedon, head down the ladder next to the Huntsman’s Minion with the boulder, enter the tunnel, and defeat the Maneater Boar.
You can now run through the sewer toward the pool of Rotted Corpses and take both ladders up to eventually reach the house with Viola’s Daughter. You must choose whether to give her the Red Jeweled Brooch that belonged to her mother, as this will effect what happens to the girl.
If you choose to give her the brooch you should immediately refresh the area and take the above mentioned path to the Maneater Boar to kill it for the Red Messenger Ribbon .
If you choose to keep the brooch, or never picked it up, and can choose to send her to Oedon Chapel or Iosefka’s Clinic. If you choose Oedon Chapel you can also kill the Maneater Boar for the Red Messenger Ribbon. If you send her to Isoefka’s Clinic you can return to Iosefka for a reward and when you enter Iosefka’s Clinic later an enemy will drop the Formless Oedon Rune, but you will not meet her Older Sister later.