Co-Creating GenAI-Generated Visualizations of People Living With Dementia: A Participatory Text-To-Image Method and Case-Based Evaluation

Generative Artificial Intelligence (GenAI) and large language models (LLMs) are increasingly shaping public perception of dementia through visual representations. These technologies often reproduce harmful and stigmatizing stereotypes that misrepresent the lived experiences of people living with dementia (PLWD). This article introduces and evaluates a three-phase framework for GenAI-facilitated co-creation sessions that centers PLWD as active co-creators in generating more authentic visual self-representations using GenAI. Through multiple case studies, key methodological and ethical challenges were explored, including strategies for effective prompting, approaches to creating recognizable yet dignified representations, and methods for including non-verbal PLWD as co-creators. Finally, the broader implications of this co-creative approach for challenging GenAI bias, future research and developing more ethical GenAI systems are discussed.