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My 81-yr old Dad has Stage 3 Rectal cancer so he has Chemo Brain but also mild dementia. He is very unsteady walking and standing. He gets up often in the middle of the night to use the restroom due to the effects of his cancer treatments. However, he often goes downstairs in the middle of the night and will have his coffee and a pastry for breakfast and will come back upstairs to bed and not remember that he did it. My parents sleep in separate bedrooms but my mom isn’t getting any sleep because she is so worried that he is going to fall down the stairs in the middle of the night or that he will fall going to the bathroom and she won’t hear him. Is there anything she can install or do so she can get much needed rest?

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Move his bed and other things to a downstairs room.
Not so easy sometimes but this is often the solution to/for homes that have bedrooms only on the second floor.
There are Bed Alarms that will give notice when someone moves in bed but those can be set off just by moving around in bed. A Floor Alarm will give notice when someone steps on it.
Either of these might be a solution BUT it just might make life a bit easier if the bed were moved downstairs. If he is going to spend more time in bed eventually at least he will be in a more active area of the house so he will not be as isolated.
And if he does not have a hospital bed that will make things even easier as the bed can be adjusted head and foot and it can be raised and lowered. This makes it easier care for someone.
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I don’t know if baby gate is the best idea, he may try to walk over it or fall. Maybe compromise would work if you leave juice and snack in his room, can he use urinator instead of trips to the bathroom?
Maybe ask doctor about some sleeping pills, those nocturnal snacks are unusual, I mean not many people have coffee and go back to bed. But your poor Mom going without sleep, for me, I know with my husband after several surgeries, few nights of not sleeping well was enough.
But, after all is said, falls happen anytime, almost nothing will prevent them, except if a person is secured in wheelchair and transferred by two people.
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I mean the simplest solution would be to convert a room downstairs into his bedroom right? That way he's already near the kitchen.
Your mom can use a baby monitor or an inexpensive security camera to keep an eye on him from her upstairs room if she feels the need to.
It's a win win for them both. Mom gets her sleep and dad gets his coffee and pastry.
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Is it a master bedroom with a bath? If so, put up a baby gate. Put is up a few inches so he can't step over it. Just the barrier my Mom didn't try to get over it.
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Someone has already suggested a main floor bedroom if not possible, Set up a personal table with a personal coffee maker (one cup) in his room that turns off automatically when finished, and place his pastry in an airtight container next to it.
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I really don't think that there is a way, if possible move him downstairs, he will roam more as the disease progresses. Safety first.
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Is there any option to make a bedroom for him on the main floor? Is there a toilet/bath/shower on that level?

Can a sign be put on the inside of his bedroom door saying that his coffee and danish are already in his room?

Maybe put a string across the top of the stairs with a sign that reminds him to not go downstairs until XX:00 a.m.?

I have read where others have used baby monitors to listen for when their LO gets out of bed, although this doesn't lend itself to good sleep for the caregiver.
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