Is ablution (wudu') required for a sick person who prays by gesturing, and how should their prayer and facing of the Qibla be?

The sick person is obligated to pray according to their ability, based on Allah’s Almighty statement: "So fear Allah as much as you are able," and the Prophet’s (peace be upon him) saying: "Pray standing; if you are not able, then sitting; and if you are not able, then on your side." If the sick person is only able to pray while lying down, they should pray lying down with their feet pointing towards the Qiblah. They should perform the prayer with movements, words, and gestures, by intention, or with their hand or head, according to their ability. If they are unable to face the Qiblah, this obligation is waived for them. As for purification, they must purify themselves with water. If they cannot do so themselves, they should seek assistance from others, even if for a fee. If they cannot find anyone to help them, they should perform tayammum and pray. If they are unable to do even that, they should pray in their current state.