My mother (57) was on methadone maintenance for over 20 years at 120-140mg. She also has end stage liver disease from cirrhosis from hepatits c/congestive heart failure as a child. She is also going through heart failure and declines any sort of PT so she is permanently bed bound. I was her caregiver for about five years and I am an only child with no relatives or family members. (I am 24) My question is this: Can a person previously on voluntary methadone maintenance continue to receive the treatment in a skilled nursing facility? Additionally, the treatment plan for methadone was denied by Humana (I am in FL) because it is an optional outpatient program. I was told the SNF that she is placed in would provide her methadone maintenance, but they have not. My mother says methadone is the only thing she lives for. She was an opioid and cocaine addict for a very, very long time. The methadone she has been on for 25 years or more on and off. She was "kicked off" of her outpatient program because of her hospitalization due to hepatic encephalopathy (comatose for a few days until ammonia level decreased from lactulose) The hepatic encephalopathy was precipitated by the methadone and i got not one, not two, but three doctors' opinions on it. Every one of them said hospital detox, then skilled nursing. My mother got out of the hospital 10 days after the first coma. She refused to walk, move legs or arms, or close her own hands. Yet if I am not around she reaches just fine. I know she is bed bound but with PT she can learn how to be mobile again. I have to drive over 60 miles to see her. I want to see her for easter but she says she will not see or speak to me if I do not get her the methadone. How do I keep my mom, my only family member, out of pain? I am just so racked with guilt and a strange sense of relief. I don't know what agency to reach out to- I believe detoxing off methadone may kill her, and if she continues to take methadone she will certainly die. But should she live longer in this state in pain? How do I help her? Thank you.