New Game ‘Before I Forget’ Highlights The Reality Of Living With Dementia

Words: Alan Wen

When it comes to portraying physical or mental impairments, video games still lag behind other media. But there has been more progress made in recent years, especially as conversations around accessibility in games and mental health has become more important.

Before I Forget, released July 16th on Steam, is a game that puts you in the first-person perspective of a woman living with dementia. It's a condition that sounds extraordinary to imagine, yet also all too ordinary - someone in the world can develop dementia every three seconds, and there were roughly 50 million people worldwide living with dementia in 2017, a figure that's estimated to double every 20 years.

When dealing with the subject matter of mental health, other games tend to bury it under metaphors or gimmicks. Take 2017's Hellblade: Senua's Sacrifice, one of the most high-profile games to address mental health. Its protagonist suffers from psychosis, but the game's setting is in Celtic times, overlapping with Nordic myth and fantasy. While it tries to depict the symptoms Senua suffers from, it also presents these as problematic gameplay mechanics, as if she has superpowers.

In comparison, there's something very refreshing about Before I Forget. The game opts for a story that can just show dementia as it is, without any high concept attached.

"We always took a naturalistic approach to the story," explains Chella Ramanan, the game's co-creator and narrative designer. "Living with dementia isn't a banal experience, even though it may be a sadly common one, and taking it to a metaphorical place could lose the person it's supposed to be about."

The game's story is a simple one, set inside a flat in London, quite positively mundane with little out of the ordinary. That is, until you start wondering why there are so many Post-it notes around the place, like one reminding you the date, or to help you if you can't remember where the toilet is. It's similar to other first-person narrative adventure games like 2013's Gone Home and 2015's Everybody's Gone to the Rapture in that you're exploring a setting and uncovering events that took place in the past, but there's a greater poignancy here because that person's story is your own.

As you interact with objects around the flat and memories gradually come back, you learn that you are Sunita, an Indian woman who immigrated to England to study cosmology before becoming accomplished in the same field while also falling in love with and marrying a successful concert pianist named Dylan.

"We wanted good, naturalistic dialogue for Dylan and Sunita's meeting," explains Ramanan. "But we couldn't afford voice-acting until very late into development, so there was also an issue of trying to really establish a romance that people invest in with no dialogue."

More than a game about dementia, Before I Forget is really a love story as we learn about how they first met. We get to see photographs accumulated over the years, and letters written to each other, while their busy and ambitious lives take them to different destinations - destinations far away from each other.

Research was done into Sunita's condition, including significant consultation with two psychiatrists, Dr Donald Servant and Dr David Codling. But the major influences Ramanan had for the story came from Richard Linklater's Before trilogy of movies - Sunrise, Sunset and Midnight - as well as Pixar's Up.

There's also moments where Sunita's symptoms are depicted - and while some can be unsettling, such as finding every door you open keeps leading back to a cupboard or walking down an ominously lit and unending corridor that you might expect from Hideo Kojima's P.T., Before I Forget never falls into exploitative horror tropes. Sunita is ultimately more than her condition.

More interesting is how her memories are brought back into vivid detail. This is partly emphasised by the game's painterly aesthetic, as colour and detail seeps back into objects you've just rekindled a memory from, as well as the immediate surroundings. But also by literally going back in time through flashbacks.

"People with dementia can get lost in a memory, and transport back to that time," Ramanan explains. "We used that symptom to allow us to see Sunita as a person who has lived a life, not just a person who is sick."

The feedback of Dr Servant and Dr Codling was used to help establish the story timeline, relative to what stage of her condition Sunita is in, to add authenticity, but it also introduced other directions the storytelling could go in. Incidentally, a symptom where 3D objects can become abstracted became the seed for some rather magical moments of stargazing, which also helps us see what inspired Sunita to take up her profession.

Before I Forget is also an important story for South Asian representation, and it does that by quite literally giving marginalised people a voice. Because while the most diverse games in the past decade have arguably come from indie developers, these are also extremely low-budget affairs that can't afford voice actors to help bring their story to life. Before I Forget changes that.

"When we finally got some funding to get us over the finish line, voice-over was one of the first things we decided would elevate production," says Ramanan. "Then it became about finding South Asian actors. In the end we found three amazing women, and we cast them all."

It probably helps that the game is on the short side, so we're not talking about hours of dialogue, but Ramanan is still conscious of how many other smaller indies don't get the investment they deserve to tell their own stories. Ultimately, during your brief time with Sunita, through her voice, her photographs, her letters and memories, you really get to see her as a whole person, who despite her condition has nonetheless lived a very fulfilling life. So even as tragic as an incurable and deteriorating condition like dementia is, and therefore one you can't as a game actually 'win', Before I Forget is still a story of hope.

"Some people have told us it helped them understand a loved one who had dementia," says Ramanan. "And that is more than we could ever hope this short game could do. I mean, that's huge and overwhelming."

Before I Forget is released on July 16th (Steam), and more information on the game can be found at the 3-Fold Games website. Follow the author on Twitter at @DaMisanthrope, and GAMINGbible at @GAMINGbible.

Featured Image Credit: 3-Fold Games

Topics: Steam, PC, Indie Games