Some say four. Others say 90. But it is inarguably within the span of precious few seconds that people forge first impressions.
That’s why lobbies are so important to long-term care facilities.
“The lobby sets the tone for the entire facility at entry,” notes Beth Kuzbek, senior interior designer for Direct Supply Eldercare Interiors. “It will convey comfort, elegance, style, and if done correctly, invite you to explore further.” 
Lobbies, foyers and entryways all have become major marketing tools for facilities in recent years, design experts say. In reaction to increasing competition for customers, facilities—particularly larger ones—have been designing lobbies with a hospitality-oriented feel. Often, that “wow” factor involves luxurious seating, natural lighting and transitional design.
Going the hospitality route in some cases has a meant a shift in the lobby’s functionality. The space has become more of a showpiece and less of a living space for residents. 
Survival of the sleekest
Competition for residents has forced facilities to up the ante when it comes to designing lobby spaces, experts say.
“I would venture that 20 percent more money is spent on finishes and things in the lobby, as opposed to other areas,” says Sandra Hodge, director of interior design for JSA Inc., an architecture and interior design firm. “We often see clients who say they’ll spend for wainscoting and natural wood in the lobby and have painted trim and molding in the dining room or living room.” 
In recent years, the importance of attracting families has made lobbies a key selling point.
“It is the most important design from a marketing standpoint,” says Laurie Smith, an interior designer with Invacare Continuing Care Group. “We’ve been told we get four seconds to make an impression on the family, so there’s not a lot of time to get their attention.” 
Notes Randy Rubin, co-owner and co-founder of Crypton Super Fabrics, whose fabrics are prevalent in long-term care: “What we’re experiencing is that the lobby is the cover to the book,” she says. “In most instances, the kids are helping to make the decision, and the prettier, the better.”
Not only is it important to impress prospective families, but conveying a certain tone to the residents is critical, as well, Invacare’s Smith adds. 
“We need to convey to them a sense of comfort and safety and warmth, the same as when you walk into someone’s home,” Smith says. 
Creating a strong, positive impression often means offering touches of luxury. A recognizable design theme, fireplaces, comfortable sofas and plenty of natural light all can pack that customer-oriented punch.   
“The use of views and the outdoors and natural light are huge factors in today’s design,” says Terri A. Prokop, design project manager with Joerns Healthcare Inc. “With the many new healthcare fabrics, textures, patterns and colors, customized furniture is now used to create an interesting and much more pleasing environment.”
Rubin added that facilities are adding some “sizzle” with textural fabrics, such as chenille, on sofas and adding bolder, more saturated colors. A snazzy-looking nursing home lobby can instantly perk up a visitor. 
“The more you are going to a place that feels under control and looking up, you’re feeling better,” she said. “A lobby is a cohesive element. You go in and say, ‘This is not such a bad place.’”
TLC Management has been seeing positive results since 2007, when it completed Village of Avon, a 137-bed skilled nursing facility, and its adjacent assisted living facility, just outside of Indianapolis. After walking through sliding doors to enter the lobby, visitors are greeted by warm colors, including greens and tans, a large window that transmits a lot of natural light, and a stone fireplace as the focal point upon entry. 
“The combination of the warm colors and fireplace … the first reaction is, ‘Wow! That is nice!’” says Dennis Ott, vice president of public relations and community services for TLC Management.
“If they turned around and left, they’d have something to talk about because you don’t find too many fireplaces,” he adds.  
Form over function? 
Hospitality-oriented lobbies, in a sense, mark a departure from their uses of years past, experts say. They often serve to entertain prospective families of residents rather than the residents themselves.
Some facilities purposely try to discourage residents from hanging out in the lobbies so that they will take part in activities in other parts of the building, Hodge says. 
“I don’t think it’s ever off-limits to the residents, but I think it’s less desirable for the residents,” agrees Jane Dailey, owner of Senior Living Design. “There’s really no reason to go in there.”
The Village of Avon’s lobby is geared to visitors and families waiting to speak to admissions officers, or for people filling out applications, says Ott. 
“It’s a functional room as well as a showpiece,” he explains, noting that residents gather in their own lobby, which is closer to their rooms.  
Meanwhile, just down a short hallway from the main lobby, residents gravitate toward the fireplace.
“The residents love the fireplace,” Ott said. “In fact, the administrator has a tough time turning off the fireplace in the summer.”
Some facilities have foregone the use of moisture-barrier carpeting and high-performance fabrics in their lobbies because they are not designed for a lot of use, notes Hodge of JSA Inc. 
Resident-centered spaces
Still, it’s also important to note that not all facilities have taken the large hotel-like approach to lobby design. Smaller facilities, and those that have been keen on the latest resident-centered movements, such as the Green House, are emphasizing a more intimate, homelike setting. 
“Yes, they are showpieces,” Rubin said. “But they also are places where they have shows and various forms of entertainment, so it’s going to be utilitarian.” 
Lobbies today are geared to be social areas and gathering places “almost like a living room where residents might meet with friends,” observes Tom Sachs, principal of the architecture firm Oudens Knoop Knoop + Sachs, based in Chevy Chase, MD. “They provide places for residents and guests to interact.” 
Regardless of the size or scope, the lobby should accommodate residents’ needs, Dailey says. That means carpeting and upholstery that can withstand moisture and stains. It also should offer patterns that take into account confusion that accompanies dementia, she explains. 
Offering a lobby area that stresses way-finding for residents with dementia shows adult children that the facility is “smart.” 
“I want them to understand some of the crazy things I do,” Dailey said. “They can point out the cueing things and way-finding things to help residents get through the building. They usually buy into the ideas. But the bottom line is, it has to look good. They’ve got to be able to sell it.” 
Rubin agrees the look has to say “successful.” While an attractive lobby encourages a visitor to see more, a dismal, dark, unwelcoming lobby does the opposite.
After glancing at such a lobby, a family member might think, “If they’re skimping on the lobby, are they skimping on the food?” 
Some designers are torn between the corporate needs of the facility and the needs of the residents. 
“It’s something I struggle with all the time because we have to please the person who owns the building,” Smith of Invacare says. “They pretty much tell me that it’s their marketing tool.”