Hi Joanne,

I totally empathise with your situation. I cared for my mum-in-law for 4 years when she was diagnosed with dementia and she is now in a care home as she is in the late stage of the disease. My gran also had many black warts & moles on her torso in her later years - she was dark skinned, brown eyes, dark haired too - I wonder if it's something that darker skinned Caucasians suffer from in later life?

My advice is that, once you get the appointment letter from the hospital, you give them a ring to discuss your concerns. If the letter gives the telephone number for Referral & Bookings DO NOT ring that number - they are just a central office that send out appointments for all departments of the hospital. They have no understanding of the way each department works. If there is no contact number for the Dermatology Dept on the letter, search the hospital website & you should find one. It will either put you through to the consultants' secretaries or to the specialist nurses office. Explain about your mum's dementia & changeable behaviour and if they have any practice in place to deal with such patients ie. can rearrange the date at short notice, can carry out any excision necessary on the day etc. Hopefully they can come to some arrangement that helps you & your mum.

One thing I would also consider is that, if an excision for biopsy is felt necessary, do you put your mum through it? The reason I mention this is because you will know that any change in surroundings, every day routine, strangers present, can be unnerving and disruptive to a dementia patient. Even if they can do it at the time of the referral appointment, it is invasive & necessitates a local anaesthetic. The excision surgery only takes about 15 minutes itself, however, if done at a later date, the lead up & the post op time afterwards makes it about a 2 hour day surgery appointment. Would your mum understand to stay still during the procedure or become agitated? If it can't be done on the day, you won't be allowed in the theatre or the pre/post op area, especially now with Covid. Would your mum be able to cope with the waiting, questions, strangers and the trauma of the op? If you feel it may be too much for your mum you need to ask the consultant what may be the outcome if a biopsy isn't carried out and what may be a cancerous mole is not removed. 

It's a lot to consider - I know it's not the same (life threatening) but we had to consider whether to get mum-in-law a referral for her cataracts removing as she was quickly going blind. After much discusson we felt that the hospital appointments & surgery would be too distressing for her & would cause her dementia to worsen (she had already been in hospital for a chest infection & her dementia had considerably deteriorated because of it). So we decided against it. 

All that being said, if you can get your mum to the referral appointment there is a chance that the dermatologist, after looking at the mole through a dermascope, will say that it's quite harmless and you won't have to worry about any future surgery. 

I hope you manage to see the consultant and that all goes well. Please let us know how you both get on.

Angie (melanoma patient)