Question: My mum had an accident at her workplace 28 years ago and has quite a serious back injury as a result. She has spent most of her time since then in and out of hospitals and bedridden. She was a bit down the other day and spoke to me of her sadness at the fact that she and my father can’t and haven’t had sex in a long time due to her injury. They now sleep in separate rooms and I know it has affected their relationship. I don’t know what to say to her about this but feel I should say something since she brought it up with me.

Answer: It’s a testament to the relationship you have with your mother that she feels she can bring these concerns and private thoughts up with you. I agree that since she has extended herself to you in this way and made herself vulnerable, that you extend back and do the same. Trust continues to be built in this way and if you show her that her private and personal worries matter to you and will be respected by you, you will be even closer and more loving as a result. You don’t have to have the answers, even saying “I don’t know what you should do about this but I’m glad you shared how you feel with me” still acknowledges and validates her feelings and indicates to her that you are someone she can trust and come to, no matter what. And that’s important.

You can give her some advice too, if you want. First, don’t pretend to know what it’s like for her. She is your mother, she has been in a long-term relationship, longer than you’ve been alive frankly, and she is sad at the impact this accident long ago has had on her relationship. While you can’t remove yourself from your perspective of being the daughter, just try to imagine what it would be like to be in love and have some external factor erode the way you can physically express that love.

It would be frustrating to say the least. It’s not uncommon for couples who have difficulty having sex, for whatever reason — illness, injury, difficulty of any kind — to slowly let that erode at the general intimacy in their relationship to the point that separate bedrooms becomes the norm. A surprising number of couples end up in separate rooms. If a couple doesn’t feel intimate and there aren’t enough positive reasons to keep them in the same bed, the need for good quality sleep can win out. Whether a person is up through the night in pain, with insomnia, or because their partner snores or rolls around or sleepwalks or whatever it may be, after years of declining intimacy, people will just eventually choose sleep first. And then once in separate bedrooms, without energetic investment and paying attention to intimacy in other ways, a relationship will deteriorate into a passionless companionship.

Now, some couples are content with this and don’t feel sad and don’t seek passion outside the relationship with another person. People find happiness together in other ways and through other hobbies and pursuits. But if your mother is sad, if she misses the intimacy in her relationship, the advice to change it is like the advice to successfully change anything in your life: one step at a time. There’s no need to get radical and say one day, ok that’s it, we’re back in the bedroom together, here are the rose petals, and I’ve booked a steamy and wild weekend away this weekend. This shock to the relationship can sound like a good idea but more often than not will not feel genuine and only serve to add pressure to an already vulnerable relationship.

Romance needs to be slowly re-integrated. Work on increasing the intimacy in the relationship outside the bedroom first. Just like in the early days, feelings become aroused through time spent together, so do just that. Spend time just the two together, your mum and dad, doing things that make you happy, make you laugh, make you enjoy each other’s company again. Hold hands. Share a dessert. Talk. Talk about everything and then talk about how you’d like to enjoy a sex life again. Have your mum go to her GP and discuss pain relieving options that might help not just generally, but during sex. If you want, also gently suggest to your mum that sex isn’t just about intercourse and maybe there are other things they would enjoy without having to involve her back so much.

However far you decide to go with your mum, from talking to inviting her to a sex toy party or going shopping together for some sexy clothes to make her feel great again or having a pampering session doing your nails together, just do it with the respect you have for her as your mother, and also as a vibrant sexual woman who misses the man she loves. You’re lucky to have a mother who feels so close to you and that’s to be honoured by doing and saying what you can to help bring her back to feeling good about her relationship again.