Keeping the wrist fold line parallel to the front edge of the mat can help, too. For some people that means the index fingers points straight ahead; for others, it can mean the middle finger point straight forward. Correct alignment of the wrist can help rebalance strength in the wrist and forearm.
Hi Stacey -- it depends...and without really seeing you or the person, I can't speak to that entirely. However, I've padded the foot bar to give the person's wrist more support and/or just have them do the Long Stretch on the floor, with the support ideas, and have them build up to having the strength to do on the Reformer. I'd have more to offer if I could see the person and their position.