An Analysis of Visits at Essex Park Rehabilitation Center: The Invariant Structure of the Human Good as Object

Professor Greg Carmer

NON310 Foundations of Work and Vocation

We discern the what ought to be praised and fixed in organizations; a very helpful way to do this is systematic evaluation of their structure. I volunteer at Essex Park Rehabilitation Center (EPRC) with the Gordon College Alzheimer’s Buddies program. It is a care center for people with dementia. My service there includes accompanying a “buddy”, a patient who has dementia. This essay systematically evaluates EPRC at a surface level. In Bernard Lonergan’s The Invariant Structure of the Human Good, a structure is set forth which Lonergan claims has presence in every organization. [1] Matching parts of an organization with his structure helps discern where the good and evil is. Using his structure, I will analyze EPRC. My first section will focus on the particular goods of EPRC, followed by the particular evils of EPRC. After, I will identify where EPRC possesses the good of order. To do this, I will identify where EPRC provides examples for the four defining concepts of the good of order: regular recurrence of particular goods, coordination of human operations (which is conditionally based on habits and institutions), material equipment, and personal status. To identify the good of value within EPRC would many more pages than I have to write. Finally, I will make a concluding statement about the overall condition of EPRC—spoiler alert, EPRC’s good outweighs its bad.

Particular goods are things, events, the satisfactions of desires; visits to EPRC are events which patients experience. Visits satisfy residents’ desire for company. The event of a greeting is a particular good, and receiving a wave goodbye is a particular good. Frank is the name of my resident, and when he greets me, he creates a particular good by that action. Systems may promote certain particular goods. Visits are promoted by EPRC, as evidenced by the employees’ encouragement towards residents to be kind to visitors. When residents go for long periods of time without any visitors, they experience a lack of the particular good of receiving guests. I am not sure how many of the patients find themselves never having visitors.

Outsiders coming to spend time with people living in EPRC satisfies a desire of the residents, thus patients will long for regular visits. Where is the regular recurrence of goods? Our weekly check-ins to EPRC. Individual goods in EPRC are either present, promoted, secured, or lacking, and when these statuses regarding the presence of particular goods become regular, the good or evil of order is established.

What allows this recurrence of visits is the coordination of human operations. Duni, my Alzheimer’s Buddies team leader drives me and four others to EPRC every week; always at 3:15 she pulls up to the chapel lot. This weekly operation of her driving to the chapel lot to arrive at 3:15 is a coordinated human operation. Unfortunately, while visiting I have often noticed loneliness from a portion of the residents. It is unlikely that they all have regular visitors. Gordon Alzheimer’s Buddies is not large enough to provide company to all of them; there are only 20 of us total. Some probably do not have relatives regularly visit. This results in an insufficiency of the good of company because there are not enough people with the regularly coordinated action of visiting with patients at EPRC.

            There are three conditions for the coordination of human operations: habits (of mind, will, and skill), institutions, and material equipment. Cognitional habits of the staff are heavily depended on, as the cognition of the residents is often low, or some bit of it is malfunctioning, requiring the greater memory of nurses, etc. The nurses must know what sort of foods different residents require to eat, if they did not know what kind of food was needed, there could be people fed hard food, who need soft food, who end up choking on the thicker food. This cognitional habit is direly important, because without it, people could choke, then experience trauma and harm. I have not seen this problem in those working at Essex park. Unfortunately, in looking at other staff’s cognitional skills I realize an absence. The secretary does not seem to know how to properly greet guests into the center. When our group walks in, most times the secretary looks at us, then refocuses her attention on the work she is doing, without greeting us and asking if we need assistance. He is young, looks 16, and perhaps has not been trained to greet visitors, and thus does not know how, making this a cognitional issue, not a volitional issue. Volitional habits—whether or not people desire to perform needed tasks, are good in my and some other residents’ desire to meet others. The people present at the home do not spend much time desiring to meet others. The man whom I accompany, Frank, almost weekly makes an effort to greet another resident, or learn their name. This volition is good because Frank’s choice to meet others cultivates an environment at EPRC where residents feel welcomed and embraced. What does not make residents feel welcomed is an irritable staff member. An activities assistant who works onh the floor where I visit with Frank. This is an open area where there are tables, chairs, a television, and often the woman who organizes these events at times is not patient with the residents. A woman was crying, and she came over and yelled at her to quiet down. The distortion of these volitional habits comes when there is a lack of patience in the employee. Skills of those involved in this corporation include working with helping people get in and out of bed. The nurses who are trained by hospitals and medical programs delicately remove and insert people into their beds. Without this skill, people would not be able to move around as much, thus suffocating people in their own rooms for long amounts of time.

            An institution is the use of name tags for volunteers and workers. Everyone who works as a part of Essex park requires a name tag with photo of the volunteer. This is an institution because it is a habit required of all, a regular occurrence and obligation of those working there. However, another aspect of institutions apply to individual residents and their medicine schedule. Those with a need for x pill y times per day have their own institutions help kept by the nurses. Even though these institutions are not held by all in this community, it is a regular, ordered practice of individuals, and two people at least partake in these events most times, at least a nurse and resident. On the converse Training volunteers is an institution. It is performed in a certain way no matter who is doing it. There are certain aspects of it which ought to be present whenever someone is teaching it. In the training we received, there was a minuscule amount of education on how to interact with the patient. Hearing about this educational piece of the program is part of what drew me to it, however, I have been let down by a teaching that did not extend much further than accompany and listen to them. I would have appreciated knowing more about how to respond when the residents we work with do not have a good memory of their past, or when they cry, or are upset by not knowing the past, or how to react when they seem inconsistent, or to be making things up. Having more situational teaching in the preparation would have better prepared trainees to interact well with their residents, and now I don’t have a regular time in which I have the chance to ask questions about these sorts of things. There is not a set time in which I can ask the staff how to react.

         Material equipment involved in Essex Park includes wheel chairs, items for residences, rooms that people are to live in, the building itself. The wheel chair allows certain residents who cannot walk the ability to easily move around or be moved around. I took Frank out onto the patio, and could not have done so without a wheel chair. This object allows people mobility, and without it many would be left, stuck in the mud of their rooms, glued to their beds, because many of these people have lost the strength to walk. However, EPRC lacks an easily wheelchair accessible doorway. I escorted Frank out onto the patio the other week, but alone I could not hold open door and wheelchair him out, a nurse had to come out and help me. Without an accessible door, more people must be involved in taking residents onto the patio, distracting nurses from other tasks they must do. If nurses’ work is less distracted, they can tend to more patients who need their expertise.

            The status of head nurse has been assigned to Inchu, and this flows out of her habits. She knows how to make decisions regarding patient treatment, she wants to do this well, and she has developed the skill of making good decisions, and doing the necessary associated communication. Lonergan describes the evil related to personal status as that which arises when people are without personal status—this could come from certain people not having any sort of relation to others. The heart of personal status lies within the way one interacts with others. Those with different habits will appropriately enter into different roles of personal status, but innapropriately into roles that they should not be presented with. The patients do not have much personal status as far as power or influence is concerned, but they do have status, as patients, and if they are presented as people without statuses, then there is evil. I have not identified any residents who are not being given the respect and treatment due to patients. One week I witnessed an activities assistant yell at a resident who was on the verge of tears. The woman kept repeating the same thing over and over, and the assistant’s response made the woman more upset. The woman was not sitting down as requested by the assistant, but there must have been a way to do this that garned less upsetness in the patient. A deficiency in assigned personal status is the woman who receives us does not have the professional skills needed to greet us well. Linda does not professionally greet us. She does not greet us with handshakes. It seems as though she doesn’t have too much concern for our professionalism of signing in. That may however have been attributed to the fact that we imposed the sign in process, or perhaps Inchu proposed it, and we simply followed along to tell Linda upstairs that we ought to have the same there. That is a lack of good in the order because Linda and Inchu are not communicating as well as they could.

Transcendental Precepts and the Development of the Subject: The Expansion of Our Concerns

What separates maturity from childhood? One aspect is the scope of what one cares about. Toddlers become self aware, and their world of cares and concerns expands no further than their own satisfactions. Over time, if they grow into maturity, their cares will grow, as well as their acting out the transcendental. At least, this is what should happen. These precepts I will list and define; I will take time to explain, and then I will go on to lay out the argument, the proposal for action, the set policy in order to coerce others into, to explore thoughts and reflections on what is required to live into these. I will lay out some key suggestions that give answer to the problem of, how does one come into expanding their, as Lonergan describes, horizon of concerns. My suggestions are: encountering the beauty of a higher good, realizing that one is capable of caring for these bigger things, and not bound by the way they view themselves, their self-perspective of what they ought to and can do. I will suggest what is needed to live into these precepts, then explore how they might affect my moral development. Finally, I will give personal policy on how I can take responsibility, or ownership, how I can take into my own hands the exhortation I have received to develop “the good that is one’s concern.”

I wonder what my current concerns are. To learn this I paid attention one day to what most pulled my attention. I noticed myself drawing attention to peoples’ physical appearances often over the past few days. Since the lecture in which we discussed the way our attention and senses are tuned to certain things we care about, I have kept a sporadic journal, an occasional diary, listing things that draw my senses, that fancy my imagination. I found breast and chest sizes to draw my attention. Then I go through a process of asking why that person is that way. Images of biological molecules and dna flood my mind. Also the thought of guys bench pressing very often.

Necessary to live into these precepts is a capacity to realize what they are. One must be trained to have the pointed out in ones’ self, and then after that they can, they have taken the first step towards actualizing their goals. The first precept, be aware, calls us to listen in to what is going on around us. We ought to use our senses and take in what is going on around us. Imagining is a way to generate data from which we can identitfy patterns. Through being aware we ought to draw from both our senses and our imagination, and be careful to not become too caught up in either, for that will lead us to base our conclusions in what is not reality (if we’re overemphasizing the use of our imagination, leaving data from our senses behind). Be intelligent begs us to make sense of the data, developing insights from that data. There will not be simply one insight we draw from whatever data we have taken in, and in order to determine which of these insights is true, we ought to exercise the next level of consciousness: be rational. This precept exhorts us to take this variety of insights, weigh them, check them against reality, and consider which one is true. When we have done this, we result with a judgment. This judgment ought to be acted upon, responded to, and this is the heart of the imperative, be rational. Ideally, these precepts move us towards apprehending, choosing, and making the transcendental notions of the good come into existence.

I can take responsibility for developing my concern. I can begin by telling myself, this is why I am doing some particular type of work—because of a larger reason. A student can initially take a course and only do the problems with the motivation of getting a passing grade, but if they are confronted with this line of thought that informs one to have a bigger perspective, they can begin to develop their perspective by simply initiating their thought on what makes for an appropriately larger concern. They might think, well, I want to do this homework for the larger goal of getting my degree. They may then talk with a mentor and ask how they can have a better, more mature, more, bigger, better, more significant and meaningful of a reason to do this homework. The mentor may suggest that ultimately there can be taking part in a college community where they are part of a group of people who are working well and performing to the point of excellence in this college setting. Later, in reflection, one may aggrandize and extend this logical direction of reasoning, to realize that they want to be part of a country which yields excellent students, and he must do his bit in the little tasks to make this huge overall goal happen.

These larger goals require an element of humility, which is part of what having a Christian perspective enables one to do so clearly. The task of the Christian is to be humble, as James Gustafson elucidated in his introduction to R. H. Niebuhr’s The Responsible Self, “The proper stance of the Christian community in its ethical reflection is self-criticism and repentance, not pride and aggrandizement.” [2] Here we are doing ethical reflection, because the question at hand is what we should do and who we should be.

Required for reflection is insights. We can ask about what our concerns ought to be, and how they can be developed. Even through the non-stop writing process of brainstorming, one will develop and realize ideas that can be used to guide them in bounding forwards in this pattern of work to grow one’s heart direction. In writing the paragraph with the illustration of the student, as I walked through that illustration, there was a moment when the insight struck me, humility is a necessary part of how to actualize this desired goal.

How can I go through moral development? An expansion of what I care and am concerned about? I have observed this shift in myself the past few weeks as we have discussed this topic in class. I have for quite a while longed to expand my horizon of concern from India and that dating relationship to broader things. I have had a pattern of forming relationships that became the center of my world.

The summer of 2011 learned to call this attitude towards dating idolatry, which was the summer after my junior year. I listened to many Timothy Keller sermons, in one he included much discussion on what makes for idols. [3] He used the image of a centerpiece, and asked, “What is the centerpiece of your life?” I immediately thought of dating relationships as the center, but that summer I was convinced that I was switching foci from dating to God. More recently I have realized that the horizon of my concern was with others’ opinions, what I often call “people pleasing”. This could more precisely be defined as the fear of man, or being primarily or having utmost concern for others’ opinions of me.

How did my concerns develop from this to the greater perspective which is involved in the cares of larger problems such as pursuing a large problem that fills God’s purposes in the world rather than smaller individual problems of a relationship.

I have seen moral development happen in myself over the course of my career as a resident advisor. At first, my concern for keeping the rules and so forth stemmed from me simply wanting to do what I had to, to fulfill my contract, but since, my concern has grown to the point where now I care about having a certain degree of concern about how the overall environment of Fulton is. I want this to be a place where people have comfort going into their rooms and their suitemates’ rooms, never afraid of walking in on people having sex, what could be a jarring, even traumatizing incident. Another thing I care about is maintaining an environment in which residents can sleep, study, and enjoy time together. That is the large mission of what the dorms are supposed to be.

Where does this shift come from? How does it happen? What caused this development in my moral status? What broadened my horizon? During Elijah Project lecture dDr. Carmer illustrated an example which had a car in it. We were explaining what it means to have a circle of cares and concerns. Driving is a precarious endeavor, and part of it involves learning to maintain a certain type of location, a certain atmosphere to one’s location. One can drive safely simply to not be harmed, or one can drive safely because they want to be part of a town in which has safe driving. This is a maturing, an expanding of one’s care. It goes from care that reaches only to self, to a care that extends throughout all of a community at large. When Dr. Carmer described this, it hit me with a moment of beauty and awe. [4]

Perhaps this moment is when I began to shift towards wanting to have this beautifully larger perspective for myself. I wanted to mature into a state of being where I care about these larger things. Where the circumstance of this other object, of this potential reality so captivates me that I yearn to work towards it. It is in this moment of awe that a person comes into a position where they begin working with more effort to build in themselves an example of the human person which they can be and grow into.

But how can one come to a point where thinking of, or seeing in one’s mind as another describes this scenario, inspires them to begin to broaden their horizons, or will every person be brought to their knees in wonder of this. Will this sort of idea stick in one’s mind as a piece of gum to the bottom of a desk, as a a virus into a body? As an infection that one cannot help but continue to reap the effects of, as C. S. Lewis wrote about in Mere Christianity near the end. [5]

The cares mature as they go from concern of the self and particular goods to caring about the transcendental notions of the good. As one develops in this, they learn to love the good, which is always out of reach, which we always yearn for, but never achieve in this life. We only taste glimpses of the good. It can be illustrated with humanity on the left of the image, and the good on the right. Through apprehending and choosing to act out the transcendental precepts we move towards attaining these notions.

Was it through becoming aware of these precepts and acting them out that I learned to care more about the notion of the good? Perhaps, that correlates with this shift I’ve seen in myself over the past couple weeks. From the beginning of the year I knew that there ought to be dorms which exist as a certain type of way, but I was still in the state of a smaller care. Even though I knew it, it did not strike me as beautiful.

         If I take and rationally examine insights I come across, I will more often hold ideas at bay before concluding that they are true. I want to learn about them. If I take these judgments and conclude that they are true I will learn that they are. Through taking Jesus’ sermon on the mount, “blessed are those who are merciful, for they will be honored.” I would take more time to critically examine where I could be merciful. Plus, I would come to act on that more.

Now that I have taken time to garner insights and judgment on the insights I have about what ones’ concern is, what the way for that to be expanded on. My judgment is that through reflection, we learn what we ought to do, our cares and concerns are expanded. Through interactions with people who have a larger perspective on life one will be advised to come to a larger perspective. Finally, these judgments are to be apprehended, acted on so that they can usher in the good that they are understood to bring in. I can respond to my judgments by acting on them. I have decided that there are some true ways in which one can incarnate the good. I have apprehended how to achieve the good, I now ought to make choices which reflect my greater concern, and allow me to take on traits which bring me into full humanity.

I choose how to spend time, and as such, I ought to choose to spend time reflecting on how I can expand my concerns. I have realized that also, through interacting with—speaking to, accompanying those who have greater concerns I can learn to expand my own. Simply observing them will lead me to learn how to act in such a way that cares about bigger things. A care of mine is underserved access to medical insurance, through taking time to learn about this more, I will expand the amount of care I have for the topic. But learning more about the topic by itself will not lead me to learn and develop a deeper drive to work towards this issue. As I learn more and more, greater problems should arise to me as I gather insights about this topic. Through realizing greater problems, a deeper call of responsibility will be placed on me. If this is my chosen field of specialty, then I ought to respond to the problems which I learn are the most significant.

At the end, I learn to more avidly take on what it is to be human. God created people to live out what Lonergan has identified as the transcendental precepts. Through spending time with people who have a larger perspective on live, who are maturely morally developed, through being taken aback—having an awe moment regarding the beauty of an expanded care, through taking times to deliberately reflect on how one can move their set of concerns, first realizing where it currently is, then pondering over how it can be expanded, we grow in our understanding of where our concerns ought to be. Through reflection we apprehend where our cares should lie, and then, this requires a final step of responsibility. Once we have apprehended what we must do to expand our moral foundation, then we must choose to act on the things which will expand our moral horizon. Further thought conducted on my cares, especially those subconscious, would reveal my concerns. This is a process people ought to carry out for themselves.



Carmer, Greg. "NON310: Foundations of Work and Vocation." Wenham, 2014.

—. "Reflectice Essay #2 Prompt: The Development of Self and the World." Wenham, 2014.

Eldredge, John. Wild at Heart. Thomas Nelson, 2001.

Keller, Timothy. "Worship." 7 July 2002. Redeemer Presbyterian Church: Seeking to Renew the City Socially, Culturally, and Spiritually. 29 April 2014 <>.

Lewis, Clive Staples. Mere Christianity. London: Macmillan Publishers, 1952.

Lonergan, Bernard J. F. "Collected Works of Bernard Lonergan: Topics in Education." The Human Good as Object: Its Invariant Structure. Cincinatti: University of Toronto, 1955. 26-48.

Lonergan, Bernard J. F. "Method in Theology." Method. Darton Longman & Todd Ltd, 1990. 3-25.

Niebuhr, H. Richard. The Responsible Self: An Esssay in Christian Moral Philosophy. Louisville: Westminster John Knox Press, 1999.




[1] (Lonergan 33-36, Collected Works of Bernard Lonergan: Topics in Education)

[2] (Niebuhr 14)

[3] (Keller)

[4] (Carmer)

[5] (Lewis 150-154)

I wrote this paper for the first course in an honors program at Gordon College I was part of: The Elijah Project. This program focused on vocation. Below you can find the syllabus for the course.