Representing the nursing profession and analyzing "pre-death" grieving in the context of dementia, A. Lindauer and A. Harvath have included chronic sorrow in a list of 20 related terms gleaned from the literature from 2000 to 2013. The concept demonstrates principles such as: pragmatism, epistemological maturity, logic, and conceptual components. Grieving continues when the nature of the loss prevents the attainment of a state of permanent adjustment, accommodation, or resolution. Chronic sorrow is appropriately applied to situations involving other conditions than intellectual or mental deficiencies. The role of fantasy is central to chronic sorrow. The fantasy of what should or could have been is predictably activated and intensifies painful emotions. The disparity between the fantasy and current living reality can be cruel and wounding. The proposed model has been constructed in a manner in which care has been taken not to characterize chronic sorrow by symptom lists and dichotomous decision points.