My 80-year-old mother has told me repeatedly — and in no uncertain terms — that she wishes to speak for herself at the doctor’s office. “I may be 80 years old and I may have had a stroke,” she declares, “but I am not incompetent. I can speak for myself.”

Not only is she adamant about advocating for herself, but she insists on being spoken to directly by members of the medical profession. “I can understand what they are saying,” she says, “and I don’t appreciate being spoken about in the third person as if I can’t take in the diagnosis, or as if I’m not there.”

In theory, I would like to support Mom 100 percent in these views. That’s because I can empathize with her desire to be her own advocate. And I can completely understand how diminished she must feel when some doctors address me instead of her when I accompany Mom to a medical appointment. When that happens, Mom is correct to see this as undermining her dignity.

If only dignity were the sole factor here, it would be easy to concur completely with Mom on this. But unfortunately, it’s often not just a question of dignity. When her safety is on the line, it becomes an entirely different affair.

The trouble is, Mom does not always provide all of the information the doctor needs to evaluate a problem fully. Occasionally, this occurs because she doesn’t see the significance of some information, or she has simply forgotten a fact or two. At other times it seems she is trying to please the doctor by giving an answer she thinks might be expected or impressive. And then there are the times when Mom wants to make a case for being seen as more independent than she can possibly be. Finally, on at least one occasion, it was clear Mom just did not want to hear a daunting diagnosis of a problem that she already knows is significant.

Despite my desire to see Mom retain her dignity and speak for herself, it becomes impossible for me to stay mum when Mom delivers information so incomplete or skewed that it seems likely this will leave her open to a misdiagnosis or practical risks. And all too often, it’s right in the doctor’s office that the conflicting desires to honor Mom’s wishes versus the necessity to keep her safe are at war in my heart — while I must simultaneously present a diplomatic front to all concerned.

I’ve learned to lead doctors to address Mom directly by refusing to speak of her in the third person myself. And I know how to cue Mom to add information herself, by saying, “Maybe you’d like to tell the doctor about another time you had problems with this.” Or I’ve jogged her memory by saying, “Do you remember the last time you had an issue with that?” But when Mom wishes to hide some information or contradicts facts I know to be true, there is no choice but to deliver the facts myself, or to signal the doctor to chat with me alone.

Inevitably, my speaking for Mom draws some ire. Because I understand her frustration, it is easy to feel rotten about stepping over the line she has drawn. At these times, the only means to quelling mixed feelings is to remember that it is actually more caring to upset Mom than to sit on the sidelines and knowingly allow her safety to become compromised.