How does a quadriplegic who cannot speak perform his prayer? Is it by intention while lying down, or must he be seated for the prayer?

If a paralyzed patient is of sound mind, his prayers are not waived. He should intend the prayer with his heart if he is unable to speak, and pray to the best of his ability. If he can only pray on his side, he should do so. It is not obligatory to seat him for prayer; rather, that is a voluntary act. He is permitted to combine two prayers due to a legitimate Islamic excuse, and he must perform ablution. If he is unable, those around him should assist him with ablution.