The objectives of this study were to investigate current conditions of home care in a depopulated agrarian region of Japan and identify issues that need to be addressed. An anonymous questionnaire survey was distributed, and responses obtained from 244 residents living in a region that has experienced population decline. Results demonstrated that 65.6% of respondents were certified as needing long-term care services, and 64.3% of respondents were receiving such services. More than half of care service users reported that they had used day care services or short-term institutionalization to help meet some of their needs. Satisfaction levels regarding these care services among users appeared to be high. Conversely, 20.5% of respondents reported that they had not used care services because of one or more of the following reasons: “Do not want to be taken care of by others,” “Do not have any need to use these services,” “Have adequate care from family members,” and “Unfamiliar with how to access them.” Female family caregivers reported that they needed the following to continue providing care: “Social welfare and health equipment rental,” “Access to facility-located rehabilitation services,” and “Support from cohabiting family members.” The results of this study suggest that professionals need to consider providing information that is easy to understand about the long-term care insurance system to care recipients in rural areas, including details of available care services and how best to access them.