gale
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My husband is very simiilar to you. starting his 5th year since diagnosis. No use of arms, legs, hands very limited. He is on his NIV 24/7 and can be off for maybe 15 minutes at a time. He cannot write and uses his computer mouse with difficulty.
He uses his ventilator with a nose mask during the day which allows him to talk and be fed. At night we switch to a full face mask.
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My husband had the same problem. Uses his NIV 24/7. He switched to a nose mask, Airtouch N20, after trying a lot of others. This one works well and he can talk and eat with it on. He uses the full face at night.