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He won't understand why he's there, and my Mom (84) will have to manage the after effects. any opinions?

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Thanks for all of the responses - Mom has POA - but counts on my opinion. I have HIPA access to Dad's Primary Doc - so I have a call in to him to see what he thinks. I appreciate everyone who took time - At this point - I'll wait to hear from the Doc. Thanks again
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The surgery is a simple one, particularly if the cancer is shallow. I would make a decision based on where the cancer is -- being near the eye or mouth would make me favor it -- and how much longer your father is expected to live. My mother had radiation treatments for a basal cell carcinoma on her nose when she was 87 and had moderate dementia. She handled it well, so I'm glad we did it. However, her new opthamologist wanted to do laser surgery to clean behind the lens this week. My mother is 91 now and nearing death. I said no to it. It may have been useful, but it could have introduced many problems and been of little benefit. We have to judge things based on the circumstances of the moment.

If my mother lives a lot longer I may regret my decision not to have her lens cleaned, but my gut told me not to do it. My brother and SIL agreed with me, which really helped me come to a decision. These decisions can be very difficult. It can help a lot to get input from other family members who understand the circumstances if possible.
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Not sure what Moh is, but dad had yet another skin cancer removed this summer (he is 88). I have lost track of how many he has had done, many different types except melanoma. This time it got infected, because he has an untreated dental infection. He needed weeks of antibiotics to finally heal.
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I had a basel cell removed. I was told they will not kill. But do get deeper. Ask the doctor. If not a threat, I wouldn't worry about it.
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My mom developed a very nasty looking black spot on her face at age 93. It looked like melanoma, to mom (who had had Melanoma before) to us and to the visiting dermatologist at the NH. We transported mom via Medical transport to his office for a biopsy that was in truth an excision of most of the growth. It was NOT Melanoma but a basal cell. The derm. told us that the choices for follow on treatment were to do nothing, or to do Mohs, or to have the NH use a chemo cream on the remaining "margins".

We opted for the cream.

I can't see a reason to do Mohs on a dementia patient at age 89. Cut the thing off/out. Are we really worried about the cosmetics?
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I would certainly ask the possible outcome if no surgery is done. And what the aftercare involves. Usually, basal cell cancers take a while to develop and at 89, your dad's body's already slowed down, so I would question whether the cancer will be an issue if it's not treated. I'd probably decline unless the untreated area would be painful for your dad and the surgery would help keep him comfortable. I hate to say it, but doctor's make money with procedures and not all doctors are practical about what their normal treatment plan is for someone close to 90.

My mom's cardiologist talked me into having an ultrasound on her heart when she was about 95 or 96. We already KNEW what her issues were, and the test said nothing except she was getting worse. I was pressured into feeling like I "had" to do it or be a poor caregiver. It was a wasted hour of major effort for both of mom and me.
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Even though, my LO had severe dementia, I allowed her to have a cyst removed from her face. It was for comfort reasons. It was swollen and she picked at it and it was getting infected. The removal went fine and they put a very thin plastic adhesive that covered it and she was not so prone to pick at it. It healed well too.

I might discuss the details with his doctor, to make sure that he could tolerate it and that he would cooperate with the aftercare for healing.
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This isn't really surgery, at least not the kind to have concerning after effects, it is an outpatient procedure done under local anaesthetic. The doctor would have to take into account that he has dementia and may not be able to stay calm and quiet for the procedure though, so if s/he isn't experienced with dementia that may be a problem.
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Who is the HCPOA? Does he have a Healthcare Advance Directive?
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Who has POA?
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