| 121 5 Interviewer: ‘Oh, that’s ok.’ Participant: [crying] (5 sec) ‘That’s ok, I cry easily when anything is, anything is going wrong.’ Interviewer:’ Hhmm Did you want to a take a little break or anything?’ Participant: ‘No, I am ok.’ Canada, Participant 3 Finally, the photo elicitation technique supported participants to meaningfully move between their reflections on the experience of the characters in the hypothetical scenario and their own experiences, helping to generate rich data about helpful advice and improving the diagnostic process and supports. Participant: ‘From my perspective, I remember when the doctor told me exactly. Again, I wasn’t fighting for diagnosis, I actually knew I had it, from my perspective. I was lucky that the doctor who, Dr [Name] was highly professional in the way she delivered the diagnosis and exceptionally supported. But as I think too what the stories I’ve heard, the majority talk about being told in a very impersonal way…. [Yes] The people that I spoke to they were shocked at first, and when I look at Thelma at her age, I’m not sure but she’s probably baffled/ confused at the diagnosis but only her carer there would know the magnitude of the devastation of such. [Yes] and one of the things I suppose I look at for older people when often they’re told it’s too late, they’re at that point in time their ability to process a bit too emotionally attached the diagnosis and what it actually means is it’s probably limited. I see her absolute uncertainty; I see her confusion. Not a good grip in reality which is what I would expect with the diagnosis. [Yes] and I think it’s lovely that the bloke is holding her hand at a point of reassurance, you know is support there. Australia, Participant 6 Deep reflections were sometimes also shared about issues such as how a diagnosis might disrupt the character’s identity or role. For example, despite being male, the photo elicitation technique supported on participant to reflect on how a diagnosis of dementia may interrupt Thelma’s identity as a married woman. Interviewer: ‘What about you, [Participant 3]? What do you think a few months later might be making a difference for Thelma about how she’s feeling about life?’ Participant: ‘Well, I think she probably has come to terms… and I think that’s the first step. Yeah. And learning how you can, uh, a - reduce the problem, the progress of the problem, you got… slow it down. I think it depends a lot on the individual, if Thelma is -If she hasn’t been out in the community and she’s spent her life…[as] a servant to the husband, being a housewife and…all of a sudden,
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