If you have some head movement, we used two devices that worked for a long time for my husband, he also had trouble with his eye lids off and on and couldn't use an eye gaze. A head mouse nano by Origin with a tablet and a very sensitive switch that we put under his one finger that worked. You put the camera on the tablet, a small metallic dot somewhere on your face that moves the cursor, then the switch to click. He could use this to communicate with us and We also had a Harmony Hub connected to the tablet( curtesy of Geek Squad) so he could control his tv, DVR, and DVD. You can also put the camera on your lap top to use it for emails, the web, etc.
Then we had a board on the wall above his tv with the alphabet and some key subjects regarding his care needs that he could point to with a laser placed on his glasses like the one on the tv show Speechless for quick communication . You can buy them on Amazon, just search " Head Mounted Laser for Non-Verbal Communication "
I don't know if you have connected with CCALS out of Falmouth, MA but they are awesome, they are an ALS nonprofit that really get it and help. They are the ones who lent us the nano head mouse and switch.