| 126 outcome which we did not address in this study despite this being a multicountry study). Bamford and Bruce (51) also suggest that exploration of the role of gender within case studies may be worthwhile. This is not only due to the perceived difference between men and women, both also the frequently ignored experiences of those who identify as gender and sexuality diverse (52). For example, in our use of photo elicitation techniques, we could have been more inclusive of cases that included men being diagnosed, female caregivers, same-sex couples, and people who express their gender in non-conforming ways. This greater diversity of images and scenarios may have been useful to stimulate a greater range of responses that could promote more inclusive service planning. We also recognise the potential value of trialling more participant driven photo-elicitation methods such as Photovoice which have also been used to promote inclusive research with people with dementia (53, 54). Photovoice involves participants independently taking photographs about something they feel is important and can provide insights into their lives (55). In participantdriven photo elicitation participants are more actively involved in selecting the photographs or visual stimuli to prompt discussion, giving more control over images and the direction of the discussion, as well as greater ownership over the research process (34). It is possible that the participant-driven photo elicitation (e.g. Photovoice) may have therefore been useful to promote deeper and more diverse understandings of the dementia diagnostic experience, meaningful time transitions, and post-diagnostic supports for people with dementia during the first 12 months. That said, for older people with dementia, all methods, including photovoice can still pose challenges (15) so care must still be taken to ensure the manageability, comprehensibility, and meaningfulness of the research process (38). Limitations It was our experience that both word association techniques and photo elicitation techniques may have some utility in overcoming dementiarelated memory, perceptual, and communication challenges described in other qualitative research (17, 56, 57). However, these techniques were not manageable or meaningful for all participants, and researchers should consider the need for inclusion criteria which recognise that to take part, participants
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