A paralized from the neck down pray’s in his bed. It is permissable for him to to pray in any direction and without wudhu.
He must have someone help him make wudu if this is possible or to perform tayammum. If this is not possible, he can pray as he is! However, Allah does not burden a soul beyond what he can bear and if he can’t pray in the direction of the Qibla due to being paralyzed, he is not accountable for this.