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I looked it up on this site: https://www.skincancer.asn.au/page/18/mohs-surgery
It sounds brilliant, though of course there are always potential complications with any surgery (or drugs). It says 14 to 20 minutes for the patient in the procedure room, under a local anaesthetic, but a wound that may need several stitches. If the cancer hasn’t spread, and the operation is affordable, and your father is otherwise in reasonable health and enjoys life, it sounds like a good idea. And yes, skin cancers are one of the big killers if they are not treated, in spite of looking relatively minor.
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Yes he should have it done. It is very fortunate it is on his hand. I had a similar procedure done on my face. My mother had to have it done on her nose. She should have had it done sooner but it worked out. These cancers can spread and cause much more concern.
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I would say unless he is near EOL to get it done, a cancer on his hand is always going to be front and centre so he is much more apt to fuss and worry and pick at it than if it were somewhere less noticeable.
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I just went through a similar dilemma with my Mom (93) who was biopsied and diagnosed with basal cell on her face. She has dementia and I was unsure how she’d react to the pain, the stitches, 2 more hour long trips to the doctor, and dealing with 3-4 hour surgery. And I worried it all might affect her dementia.

I did a lot of googling on the subject of skin cancer treatment for the elderly. Some research now is that elderly (over 85) will probably succumb to other factors before non-melanoma skin cancer can be fatal. The thought is that treatment where life expectancy is <5 years, may not be necessary.

We certainly are not against Mohs surgery...my husband has had probably 40 surgeries for various basal, squamous, and melanomas. But we decided it might not be a good idea in Moms case. She does not handle pain at all, and is a “picker” so would probably pick the stitches, so I decided not to put her through it. Her regular doctor completely agreed, and thought I was kind of crazy for even considering it.

Here’s a link to some information. You need to do your own research, perhaps ask his normal physician and decide what’s best for your dad. Does it bother him? That might be a consideration as well. Mom just thought here’s was a pimple and didn’t really care about it. We never told her it was cancer. Good luck, it’s so hard making these decisions, but we muddle on, doing the best we can.

https://mavendoctors.io/cancerconnect/skin-cancer/surgery-may-not-be-best-in-elderly-patients-with-nonfatal-skin-cancer-kA1LS_YC70yCmxM1XVG7tg/
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I had Mohs surgery on a cancer on my face on the upper part of my nose and corner of my eye. They actually took way more flesh then I thought they would.. and had a plastic surgeon to do repairs. I wasn't asleep for it.. and they do a layer.. send you to the waiting room.. test what they took off. .. and called you back to take more layers out .. if necessary.

Afterwards I had to be very careful about even touching it and not disturb the wound. I would be concerned how a person with dementia could deal with that. .. just from my experience with my Dad and surgeries of any kind.
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My mom had a little keratosis on her chest that started causing her trouble when she was in her early 90's and given her age we decided to just watch and wait. I kind of wish we had dealt with it when it was small because although it was never life threatening it went through a constant cycle of scab, putrefy, slough and bleed eventually leaving a nickel sized ulcer when she died at 99. Mohs is the modern way to treat skin cancers but depending on the size it may be able to be treated with liquid nitrogen or just a simple old fashioned excision - be sure to ask about other options.
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