Answered by Shaykh Hamza Karamali, SunniPath Academy Teacher
In the Name of Allah, Most Merciful and Compassionate
An old or chronically ill person who is unable to fast must feed 0.51 liters of staple food to a poor person for each fast day that he misses. If he is too poor to even perform this expiation–as described in the question–he is not obliged to do anything at all. The unpaid expiations, in other words, do no accumulate for future payment. [1]
Such a person should gratefully accept the mercy that Allah has shown him and channel his gratitude to find other ways to take advantage of the blessings of Ramadan. If he desires to serve his All-Merciful Lord, meaning that he would have fasted were it not for his illness, and he would have paid the expiation were it not for his poverty, he is nevertheless rewarded for the fast and expiation even if he doesn't actually perform either one. [2]
And Allah Most High knows best.
Hamza.
[1] Ahmad Ibn Hajar al-Haytami, Tuhfat al-Muhtaj fi Sharh al-Minhaj, Kitab al-sawm, Fasl fi bayan fidyat al-sawm al-wajib, Commentary on Nawawi's words, wa al-adhhar wujub al-muddi `ala man aftara lil kibar
[2] The Companion Jabir ibn `Abdullah al-Ansari said, "Once we were
with the Prophet, may Allah bless him and grant him peace, on an expedition
and he said, 'There are certain men still in Madina who have accompanied
you on every stretch you have travelled and every valley you have crossed.
It was only illness that prevented them from coming.'"One variant has, "from their sharing the reward with us." (Muslim)
And the Prophet (Allah bless him and give him peace)
said, "When a servant of Allah is sick or traveling, he is given the
reward for what he used to do at home when healthy." (Bukhari)
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