In Islam, the daily prayer (Salah) is a fundamental duty for every Muslim who has reached puberty and is of sound mind. For individuals who do not meet these criteria, the obligation of prayer does not apply. This is affirmed by the Prophet Muhammad (peace be upon him), who stated that children and those who are mentally incapacitated are exempt from accountability (Sunan Abu Dawood, Hudood, 16; Ibn Majah, Talaq, 15).
However, there are exceptional circumstances in which prayer may also be waived for those suffering from serious health issues. According to the Hanafi school of thought, individuals who are too ill to even move their heads in prayer are not required to perform Salah. If they pass away in this state, they are considered to be free from the obligation of making up the missed prayers and thus meet Allah without any prayer debt. In cases where recovery occurs, the individual is required to make up for a single day’s worth of missed prayers. If the number of missed prayers exceeds this, they are generally excused from making them up.
For those who fall into a coma, the ruling is similar and is based on the duration of unconsciousness. Imam Shafi’i, for example, maintains that if a state of unconsciousness lasts for an entire prayer time, the individual is exempt from making up for that prayer (al-Sharbini, Mughni al-Muhtaj, 1/314).
For individuals who are bedridden indefinitely, there are specific accommodations for performing Salah. If they cannot rise from bed or perform ablution (wudu) and there is no one to assist them, they may perform tayammum, a dry ablution, using a stone or brick kept nearby. If turning to face the Qibla or sitting up is impossible without help, they may simply direct their face toward the Qibla as best they can and perform prayer with gestures.
In extreme cases where even tayammum is unfeasible, such as if the person cannot move or has no assistance, they may perform Salah by simply intending to pray in their heart. If the individual later regains their health, they should make up for the missed prayers. If they do not recover, the obligation to make up the missed prayers is lifted (Ibn Nujaym, al-Bahr, 1/168, 172; al-Haskafi, al-Durr al-Mukhtar, 39; Ibn Abidin, Radd al-Muhtar, 1/252-253).
In all of these cases, Islam provides flexibility, ensuring that prayer remains an accessible act of devotion for every believer, regardless of their physical or mental condition.