NOTE: This spoiler was submitted by Jeremy

In October of 1931, the world’s most notorious gangster, Alphonse “Al” Capone (Tom Hardy), was arrested for tax evasion. While in prison, his mind began to rot away from neurosyphilis and dementia. A decade later, after no longer being deemed a threat, Capone (“Fonse” to his friends and family) is released and sent to live in exile in Florida with his family.

Fonse walks through a dark hallway in his home while carrying a fire poker. He goes into a closet and finds a little girl in there. They scream at one another, but she runs out and joins Fonse’s other grandchildren, nieces, and nephews as they all play outside. The children pile on Fonse, who is having fun until the kids are told to get off of him. In the bushes, someone is observing the man and his family.

Fonse has Thanksgiving dinner with his family, where he tells one of his granddaughters what Thanksgiving is to him. His speech is strained from his illness. He dances with his wife Mae (Linda Cardellini) until his sister Rosie (Kathrine Narducci) tells him he has a phone call. Fonse’s estranged son Tony (Mason Guccione) is calling, but when he answers, he doesn’t appear to show interest in talking to him, or even seem to remember him. He is later outside on the porch talking to his sons Ralphie (Al Sapienza) and Junior (Noel Fisher), all while some agents are listening in on the conversation. Fonse just hacks up goo and wets himself. Junior goes to get something clean while his father orders him not to tell his mother. Fonse then listens to a radio broadcast of a fictionalized account of his crimes.

Fonse has people move his prized possessions out as they are now being sold off to repay his debts, despite his objections. From a distance in the woods, he can see someone hiding, and he knows they are watching him. Later that night, he has a vision of a young boy in his room. Soon after, Mae wakes up in horror to see that Fonse shit the bed.

Mae calls for Dr. Karlock (Kyle MacLachlan) to come in and check on Fonse. After seeing him react hysterically over a little noise, Karlock recommends to Mae that she keep his family there to keep an eye on him.

An old friend of Fonse’s, Johnny (Matt Dillon), shows up after supposedly being called by Mae. He talks to Fonse and comments on his health and appearance. Johnny then takes Fonse to go fishing. On their boat, Fonse talks about hiding $10 million away, but he can’t remember where he put it. As he tries to fish, an alligator takes his catch, and he angrily retaliates by shooting the gator dead.

Fonse later watches “The Wizard of Oz” with Mae and dances with her. He excuses himself to pee and starts to do it outside, but he catches one of the people spying on him standing directly in front of him. However, due to his lack of a grasp on reality, he doesn’t bother reacting to it. He goes outside after being called by Johnny. He asks Fonse if he’s talked to Tony in a while. Fonse starts yelling for Mae, saying he wants more bourbon for his friend, but Mae only sees him sitting next to an empty chair. When she denies his request, Fonse yells and spits at Mae, leading her to slap him until he’s on the ground. She helps him up to his bed and he starts rambling until the doorbell rings. Mae answers it and finds Fonse’s head bodyguard Gino (Gino Cafarelli) there checking in on them. She assures Gino everything is fine, but she reminds him not to call Fonse “Al”.

Fonse then calls the police, thinking he has been kidnapped. The agents outside are listening in on the call. After he hangs up, he wanders the halls again and goes into the basement, where he sees himself in his former glory being welcomed by admirers, just as he faintly hears Mae calling him. Fonse then finds himself walking into a room where Gino is standing over a man who has been tied up. Gino starts viciously stabbing the guy in the neck repeatedly. After Gino leaves, Fonse encounters a showgirl who is apparently the mother of Tony. Before she starts telling him about some kind of treasure, she is shot dead. Fonse walks downstairs to find everyone from before all dead. He runs outside and sees Tony as a child. He follows after him, tripping over other dead men, until a car appears to come hit him. In reality, Fonse just suffered a stroke and has collapsed, with his family trying to get him up.

Mae calls for Karlock again. After he gives his diagnosis and advice to the family, he meets with FBI Agent Crawford (Jack Lowden) to report on Fonse’s condition, as it appears that they are trying to find out whatever information Fonse can come up with on the whereabouts of his fortune. Karlock has Fonse start holding a carrot in his mouth in place of a cigar, and he tries to perform tests to see what Fonse can say about his money.

Ralphie talks to his father and insinuates that Fonse’s own people are trying to get him. This causes him to become more paranoid around everyone, such as during dinner when he hallucinates that Gino’s steak is getting bloodier as he cuts it, making him freak out and hit the floor. After he is put to bed, Johnny once again appears by Fonse’s bedside, just as he hears another radio play of his crimes, this time detailing how Fonse murdered Johnny after he allegedly sold him out to the feds. The man Gino was stabbing in the earlier scene was Johnny. Johnny maintains his innocence, but gouges his eyes out and forces Fonse to look at them. He starts screaming in terror before Mae and the nurse come in.

Crawford continues to push the case against Capone to his bosses, who are fed up with having no leads after all this time, but he is confident that Fonse is ready to spill the beans sooner or later. Crawford goes with his partner Harris (Josh Trank), where they sit with Fonse and his attorney Harold Mattingley. Although Crawford does his best to egg Fonse on to get something out of him, the interrogation is cut short when Fonse once again craps himself.

The following afternoon, Fonse disappears and nobody can find him. He has gone to retrieve his Tommy gun, and he starts firing wildly in front of the house. He starts to shoot his bodyguards, ending with him killing Gino. He then goes after the men in the woods until he briefly remembers a hint to his fortune’s location (“Dig where it’s wet”) before he falls into the lake. The water appears to recede and engulf him in a tidal wave that washes him up to an old farmhouse in Italy. He is met by a young boy before being woken up by Mae, Junior, Ralphie, Rosie, and a very much alive Gino. They help the old man back up on his feet.

Sometime later, the family gathers for Thanksgiving again. Mae has invited Tony, who had been calling repeatedly for a while but never spoke. He sits down with Fonse, and while the two don’t talk, they sit together and observe the view.

Final text states that Capone’s family changed their names after his death and moved away. His fortune remains unfound to this day.

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The film is a look at the final year in the life of notorious gangster Al Capone (or "Fonse" to those closest to him) as his mind deteriorates from neurosyphilis and dementia.

Fonse is haunted by his deeds as a gangster, such as the murder of his friend Johnny. In the present, FBI agents are trying to gather information on the whereabouts of his supposed $10 million fortune, but Fonse is not able to provide any clear information as his speech is impaired and he loses control of his motor functions.

Fonse's family continues to look after him until his death, after which they change their names and move away, while his fortune was never recovered.