Hi Nicole, As each person experiences the progression of this illness a little bit differently (or even very differently) there is no guidemap of exactly what to expect next. My father, for example, lost his ability to straighten his spine first, then strength in his arms legs faded such that he was dependent on a walker, next his swallowing became difficult until he could only eat blended food. He could still talk until the end, though it was a little harder for him to enunciate, and just a short conversation exhausted him. I had gotten it in my head that he would become much weaker and be unable to walk or move his hands at all before he lost breathing function, but this was not how it went. He was able to button his own shirt, albeit slowly and with great effort, until the day he passed away. This is quite different from any number of other people with ALS. One thing that appears to me to be consistent is that the illness keeps progressing and people have to adjust, some quite rapidly, to increasing disability. It seemed to us that we were just getting used to a new need when something else, and more serious, developed that had to be coped with. If it is possible, try to stay one step ahead with equipment that will be needed, as when you need it you really need it soon if not immmediately. A suction machine was quite helpful at first, but became critical just days afterward. We had a bath slider waiting in the store room though dad still could climb over the edge of the tub to use the bath chair.