As a CALS, I would start looking for support before you actually need it. If your cals is hesitant because it is another hassle, validate that feeling, as it IS a hassle and takes time and lots of effort to secure the right help. It can be very frustrating. Start with your clinic’s social worker, reach out to your local chapter of the ALS association, and realize folks with experience working with ALS are rare and you are looking for someone who is willing to learn the myriad of equipment and not someone who tells you what they can’t do. Don’t be afraid to trust your gut about who an agency sends and to try another agency. They usually start with their best person, so if that person isn’t right, switch to a different agency. Start with just a few hours a week, the best help I have found comes and gets my pals up, dressed, shaved, etc, a few days a week. I have had the experience of an aide with the ‘deer in the headlights’ look, but found a subsequent one who has been wonderful. Make a list and take breaks when the search gets overwhelming.