I don't know if they fall will actually speed up the progression, or that you tend to ignore it for it while, and then it hits you in the face. Literally. So definitely be more careful because you can fall and break a hip, or break your nose, etc., and you can also fall out of your wheelchair.
I was diagnosed nearly 3 years ago now, and looking back at this was lucky that it's been slow progression, but it does seem to speed up every now and then. it seems that things stay the same for a while and all of a sudden you wake up then you can't do something that you could last week. Up until last year, I could go up and down the steps to my Victorian house. Now I can't stand up to pivot and turn. At some point in time, both your brother and his wife are going to need more help, and ignoring it isn't going to make it go away. Despite my tendency to ignore it myself, I just try to stay busy with things, try to think ahead and get equipment before I absolutely need it, so when I do need it, it's been sitting there in my living room for a while and I'm used to looking at it. I ordered my wheelchair last spring, but use the scooter until the fall when I couldn't stand up anymore. Now I use my wheelchair for everything.
So stay strong and optimistic look for clinical trials, and contact the ALSA and MDA groups in your area for help. They have loaner closets, social workers, ALS clinics, and more. And try to get them to come on the forum it really is a lifeline for many of us.
As a matter of fact, some of my forum friends have made plans to meet this month! I wish I could meet with them, but can't afford the travel...
