Rethinking surgical approaches for patients with dementia and skin cancer

An innovative pathway was developed for performing skin cancer surgery under local anaesthesia for patients with dementia. The initiative involves comprehensive pre-operative assessment, including mental capacity evaluation, and personalised support throughout the surgical journey. By avoiding general anaesthesia, the approach reduces risks of post-operative delirium and mortality while improving quality of life. The pathway has demonstrated significant benefits for patients, carers and the trust, including cost savings and enhanced staff skills in dementia care. This model offers valuable lessons for adapting surgical practices for vulnerable patient groups.

In this article…

• Dignifying surgery for the person with dementia and skin cancer

• How local anaesthesia can reduce the risk of post-operative delirium

• Identifying an alternative pathway to benefit patients, staff and the trust

Nursing Times Awards

This initiative won the Theatre and Surgical Nursing category in the 2023 Nursing Times Awards.

To find out more about the NT Awards go to awards.nursingtimes.net

Key points

Patients with dementia should be assessed before any surgical decisions are made

Local anaesthesia should be considered as a safer alternative to general anaesthesia in appropriate procedures

Patients with cognitive impairments should be provided with continuity of care and personalised support throughout the surgical journey

Effective communication skills and distraction techniques can support patients during procedures

Collaboration across multidisciplinary teams can help create holistic, person-centred care pathways for vulnerable patient groups