Chronic Dizziness While Fasting
Question

My husband suffers from chronic dizziness due to vestibular neuritis, and during Ramadan, his condition worsens with fasting, and he is unable to stand for the Salah of Fajr due to severe dizziness and loss of balance. During bouts of dizziness, he becomes almost unconscious, does not respond to me, and is unable to comprehend what I say. My husband is a student of knowledge, devout in his religion, and all praise is due to Allah, and it saddens him that he cannot perform Salah, especially during Ramadan. I try to help him with Wudu’, and he prays while lying down, but sometimes the call to Fajr prayer comes while he is in a state of major ritual impurity, and he is unable to perform Ghusl, so he does not pray Fajr until after the dizziness ends, and sometimes the attack lasts from Fajr until Maghrib when he breaks his fast, then he makes up the missed prayers afterward. Is it better for him to break his fast during the bouts of dizziness so that he can perform Salah on time? And if he experiences an attack while in a state of major ritual impurity, is it permissible for him to perform only Wudu’ and pray to avoid missing the prayer time, or should he wait until he is able to perform Ghusl? He always tells me that he cannot concentrate or have the proper reverence in his Salah during an attack. He is confused about what to do; should he wait until the bout of dizziness ends, or should he continue to pray while lying down to preserve the prayer time?
Praise be to Allah.Firstly:
If fasting increases the likelihood of your husband experiencing dizziness, or prolongs its duration or intensity, then it is permissible for him to break his fast when he feels an onset of dizziness, and also to break the fast after the onset if it alleviates his condition.
Allah the Exalted says (translation of the meaning): {O you who have believed, decreed upon you is fasting as it was decreed upon those before you that you may become righteous - [Fasting for] a limited number of days. So whoever among you is ill or on a journey [during them] - then an equal number of days [are to be made up].} (Al-Baqarah 2:183-184)
The illness that permits breaking the fast is one that causes evident hardship to the fasting person.
An-Nawawi said in "Al-Majmu'" (6/261): "The ill person who is unable to fast due to an illness that is hoped to pass is not obliged to fast... This is if he experiences evident hardship by fasting. It is not required that he reaches a state where he is unable to fast, but our companions have said: The condition for permitting breaking the fast is that he experiences hardship by fasting that is difficult to bear." End quote.
Sheikh Ibn `Uthaymin (may Allah have mercy on him) said: "The sick person has different states:
The first: He is not affected by fasting, such as a minor cold, a slight headache, toothache, and the like, so it is not permissible for him to break the fast, although some Jurists say: It is permissible for him due to the generality of the verse {So whoever among you is ill} [Al-Baqarah 2:185], but we say: This ruling is qualified by a reason, which is that breaking the fast relieves a burden from him, so then we tell him to break the fast. But if he is not affected, then it is not permissible for him to break the fast and he must fast.
The second state: If fasting is difficult for him but does not harm him, then it is disliked for him to fast, and it is recommended for him to break the fast.
The third state: If fasting is difficult for him and harms him, like a person suffering from kidney disease or (certain types of) diabetes, and the like, then fasting for him is prohibited." End quote from "Ash-Sharh Al-Mumti'" (6/341).
Secondly:
If he experiences a bout of dizziness while in a state of major ritual impurity, it is obligatory for him to perform Ghusl for Salah, and it is permissible for him to combine Dhuhr and `Asr, and Maghrib and `Isha, either by bringing them forward or delaying them. If the bout continues and he fears the time for Fajr, `Asr, or `Isha will expire, it is permissible for him to perform Tayammum; because he is sick and unable to use water, and he only delays the Salah to the end of its time in the hope that the bout will pass.
Thirdly:
A person is required to pray standing, but if he cannot, then sitting, and if he cannot, then on his side; as reported by Al-Bukhari (1050) from `Imran ibn Husayn (may Allah be pleased with him) who said: "I had hemorrhoids, so I asked the Prophet (peace and blessings be upon him) about the Salah, and he said: 'Pray standing, if you cannot, then sitting, and if you cannot, then on your side.'"
It is not permissible for him to delay the Salah beyond its time except in the case of combining prayers.
Shaykh Al-Islam Ibn Taymiyah (may Allah have mercy on him) said in "Majmu` Al-Fatawa" (24/14): "The sick person and the one with continuous bleeding (mustahadah) may combine prayers." End quote.
Lack of concentration or devotion does not harm him.
We ask Allah to heal him, grant him well-being, and reward him for his affliction.
And Allah knows best.