After Japan’s major nuclear accident in 2011, approximately 150,000 Fukushima residents were ordered to evacuate. Beginning in 2015, the evacuation orders have been systematically lifted. However, the health impacts of allowing residents to return to homes in areas previously uninhabitable due to nuclear radiation remain poorly understood.

Declaring radiation levels to be safe does not necessarily eliminate the concerns of residents about the effects of radiation exposure. Rebuilding medical, welfare, and commercial infrastructure and services takes time. Nontangible community elements, such as mutually dependent social networks, also require time to be re-established. Nevertheless, the Japanese government prioritizes policies that encourage evacuees to return home as soon as it is safe to do so.

Post-disaster evacuation situations and subsequent return home pose substantial—and as yet relatively unknown—mental and physical health threats for those affected, especially those in vulnerable groups, such as the sick, the elderly, and children.

Here we report a case of an elderly female evacuee with dementia, who was prevented from returning home after her hometown evacuation order was lifted, began exhibiting marked behavioral abnormalities. Loss of emotional ties that were created while she was housed in temporary accommodation appeared to be a critical contributing factor.

How can social participation by older people support their wellbeing? We explore the elder-focused community support system developed in Minamisanriku town after the Great East Japan Earthquake of 2011. Many elderly people lost all their material possessions and were moved from their devastated home communities to temporary housing. We conducted semi-structured interviews with 17 participants including 14 community workers and three members in the Minamisanriku Council of Social Welfare (MCSW) in a programme framed by the MCSW's disaster-response model. Thematic analysis highlighted how older people's involvement in the visiting programme of their temporary community, and conducting twice-daily visits to other vulnerable elders, enabled them to provide valued social support to isolated and homebound peers. It also helped reconstruct their own social identities shattered by the dissolution of former communities, the shock of displacement and loss of possessions. This positive social participation was heavily influenced by strong bridges between their temporary community and MCSW support staff and infrastructure that promoted and supported their visits. Our study highlights how strong and empowering relationships amongst older people can be facilitated by an active government-funded support agency that is immediately responsive to the needs and deeply respectful of the world-views of vulnerable groups.