Last week, a Spanish-speaking man in his late 70s wandered into my open bay prison dorm. We have 86 bunks. He meandered to the back, passing row upon row of steel frames, shuffling a metal walker down an aisle, looking for what he assumed was his assigned bunk.

Upon reaching a bed in a far corner of the dorm, he raised his head and found another man in his bed. He made eye contact. A deep sense of dread, anger and confusion settled.

Fortunately, a large number of people in prison speak Spanish. Neighbors swept in to diffuse the situation. The group, sensing our visitor’s mental state, discovered that he was lost. The man was actually housed across the compound and wandered into our dorm — totally unaware of his error. It was also revealed: he did not speak English, was new to prison, and had some kind of neurocognitive disorder such as late-stage dementia.

Florida has a problem.

And, with the upcoming legislative session looming, policymakers statewide may be poised to address the issue head on. Advocacy groups and policymakers are unifying forces to address the issue of neurocognitive disorders in the criminal justice system.

Believe it or not, a huge number of men in our dorm possess neurocognitive dysfunction. As recently as 2024, People Magazine reported that while fewer than 10% of people in the public have a Traumatic Brain Injury (TBI) about 50% of prisoners do. Neurocognitive disorders such as dementia, Alzheimer’s, Parkinson’s, vascular disease, frontal temporal degeneration, TBI and more are especially common in elderly inmates. This is most jarring due to the fact that approximately one-third of the people in prison are considered elderly.

Worse still, in instances of frontal temporal degeneration, 37% of people diagnosed with this impairment experience their first symptom as committing a crime. Meaning, for many people, we don’t even know they have an issue until a crime occurs.

The problem is that the state of Florida does not currently consider these disorders as a criminal defense or official relevant factor in sentencing. Instead, it is up to the prosecutor and/or judge’s discretion as to a plea offer and final sentencing. The issues are twofold: the basic inhumanity of sentencing a person to retribution-based prison when he or she may not understand why his or her action was wrong to begin with; and if the case went to trial, the state may have a substantially challenging time proving a defendant’s necessary criminal intent.

How can a person who is so unaware of his surroundings that he wandered across a prison, looking for his belongings, be culpable for any more complicated action? Yet, Florida does not allow people with neurocognitive disorders to raise these issues as a valid defense. You might be thinking, “Well, why didn’t these people just go to trial? Shouldn’t their defense counsel have forced the issue?” Few defendants have the financial means to hire competent counsel.

This is why almost all criminal cases end in plea bargains and scholars worldwide raise valid objections to a plea bargain system which has a de facto effect of completely undermining the purpose of the Sixth Amendment’s right to a fair trial. This is especially true for people with neurocognitive disorders who are both potentially less culpable and unable to raise a defense in a trial setting.

People with neurocognitive disorders in Florida have no effective defense or remedy pre-trial which forces the state to consider reducing their criminal liability.

This fact should spike terror into the hearts of all people with elderly loved ones. Imagine losing a sister, father or spouse to the maw of a dispassionate criminal justice system which overlooks a defendant’s neurocognitive disorder — a condition scientifically proven to affect cognition. Neurocognitively impaired individuals are not entitled to a criminal defense or their condition being considered as a relevant factor in sentencing. Instead, they are forced to accept a plea offer because the one defense they should be able to raise at trial is not permissible, making the penalty of trial less of a gamble and more of an inevitability. Worse still, many people diagnosed in this situation are elderly and facing unalterable life changes already. To punish society’s most vulnerable members (for crimes they may not understand and with a prison system which will only increase their confusion) without consideration of their full condition speaks volumes as to our state’s propensity for blind retribution.

The upcoming legislative session marks an opportunity to right this immoral and coercive failing in Florida’s criminal justice system.

Chris Salamone, incarcerated in Florida, is a criminal justice advocate.

https://www.orlandosentinel.com/2025/09/06/commentary-stop-incarcerating-people-with-alzheimers/