I'm a nurse and had several ALS patients that I did in home care with. Started with a 43 year old man who was still speaking and sitting in a wheelchair the first day I arrived to care for him. At the end of 3 years, he was total care and on a respirator. I was there every step of the way with him. Had more ALS patients to follow. They become so special to you!!!
ETA: What ended up being the correct diagnosis for your buddy?