This retrospective observational study aimed to look into the social demographic change of the occupants of a long-term care (LTC) facility that was constructed in 2015 as a restoration support after the Fukushima Daiichi nuclear power plant accident.

The social demographic information during 2015–2021 of occupants in the Kawauchi Special Nursing Home was analyzed.

A total of 172 participants were included in the analysis. The number (proportion) of evacuees was 37 (69.8%) in 2015, then gradually decreased to 7 (31.8%) in 2018, yet increased to 21 (58.3%) in 2019. There were 121 occupants (70.4%) who were from Kawauchi Village and other municipalities of the former evacuation area.

The Kawauchi Special Nursing Home initially received people who hoped to return to the former evacuation zone; however, its role changed to receive people who became in need of LTC after returning to Kawauchi Village. The construction of LTC facilities in the former evacuation area may help enhance the local LTC service where returnees are rapidly aging.

It is crucial to determine the health status of returnees to former evacuation areas. We aimed to examine the long-term care (LTC) utilization rate among elderly returnees as the indicator of care needs.

This study used a resident registration database to collect information on LTC utilization rate among elderly returnees to former evacuation areas in Fukushima, Japan, following the 2011 Fukushima Daiichi Nuclear Power Plant accident. LTC utilization rates were descriptively analyzed.

For all age groups, the LTC utilization rates were lower among returnees than evacuees. The LTC utilization rate among returnees in each age group (chi-square test results compared to evacuees) were as follows: 0.78% (P = 0.194) for those aged 65–69, 0.69% (P = 0.003) for those aged 70–74, 3.23% (P = 0.007) for those aged 75–79, 6.79% (P < 0.001) for those aged 80–84, 22.84% (P = 0.011) for those aged 85–89, and 44.09% (P = 0.089) for those aged 90 and over.

Elderly returnees had fewer LTC needs than elderly evacuees. Nevertheless, the proportion of aging people is high in evacuation area, meaning the number of elderly returnees would increase at an enormous rate. Therefore, LTC utilization rate would increase in the future.