"We are left alone": A qualitative study of life satisfaction of older adults in rural Nepal.

Older adults in rural Jumla, Nepal experienced low life satisfaction largely due to youth out-migration leaving them without expected familial caregiving support.

• Semi-structured, in-depth interviews were conducted with twenty older adults in Jumla, Nepal
• Participants described being 'left alone' as children migrated away from rural communities for economic opportunities
• Filial discrepancies — gaps between expected and received family support — were a central theme in participants' experiences
• The study used an interpretive phenomenological approach guided by thematic data analysis

Despite experiencing abandonment, older adults expressed a desire for their children to succeed even at the cost of their own care.

• Participants simultaneously expressed loneliness and low life satisfaction while endorsing their children's migration decisions
• This tension reflected a conflict between traditional filial piety expectations and acceptance of a changing economic landscape
• Older adults sought to embrace changes in economic and social structures even as they struggled within these systems

Political and religious dynamics were directly connected by older adults to their perceptions of low life satisfaction.

• Participants linked dissatisfaction with life to broader political conditions in rural Nepal
• Religious beliefs and traditional practices served as coping mechanisms for situations perceived as outside personal control
• Tradition provided a framework for meaning-making in the context of social and economic upheaval

Existing metrics of life satisfaction and mental wellbeing were found to be inadequate for capturing the experiences of older adults in rural, low- and middle-income country contexts.

• The study identified challenges faced by Jumli older adults that 'cannot be measured by existing metrics of mental wellbeing'
• Few prior studies have investigated mechanisms of life satisfaction in rural environments in low- and middle-income countries
• The authors call for future research to address life satisfaction in rural contexts 'that may not fit into extant metrics of life satisfaction in older adults'

The aging population in South Asia is rapidly growing, creating an urgent need to understand subjective mental wellbeing of older adults in culturally specific contexts.

• The study was situated within the broader context of a rapidly growing aging population in the South Asian region
• Aging and life satisfaction are described as 'complex processes that are experienced differently in various sociocultural contexts'
• The rural setting of Jumla, Nepal was specifically selected to examine underrepresented low- and middle-income country perspectives