Choosing a wheelchair is a major decision. Making the right choices is essential in determining your long term happiness with your chair as well as factors like comfort,maneuverability,dependability and long term usefulness. In my experience most prosthetic people are not educated about the needs of
ALS patients.
I have been fortunate in that the V.A. has updated my chair as needed (total cost around $40,000) but if I could do it over I would have ordered the RIGHT chair on the first try.
I have an Invacare Storm TDX3. It was initially ordered with tilt and recline. The gel seat pads proved to be very uncomfortable. As it became more difficult to stand the low seat height made it much harder to get out of the chair unassisted.
Here are my recommendations:
Get a mid wheel drive. It is much easier to maneuver in tight spaces like a van. Or tight doorways.
I prefer a molded seating system with good lumbar support.
Arm troughs will be needed as arms become weaker.
Get a fully adjustable headrest. The wrap around type makes it more comfortable to nap.
Order a vent tray and store it until needed.
Power footrests aid in comfort and toileting.
Tilt and recline allows you to shift pressure points for more comfort. It can also lower your overall height for low van door openings.
Most chairs will only operate in slow mode if it is at more than a 6% tilt/recline or is elevated. Any good dealer can disable this safety feature for a more comfortable ride or for easier loading through low van openings.
Anterior Tilt System and Elevate are essential in the later stages of
ALS. It has been an invaluable aid in standing and for transfers. Plan your wheelchair needs for the late stages of
ALS.
Plan your electronics to accommodate an alternate control system such as sip/puff or an ASL head array.
Hope this helps someone.
Regards
THERE IS NEVER TIME TO DO IT RIGHT, BUT THERE IS ALWAYS TIME TO DO IT OVER.
Choosing a power wheelchair 
