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

The aging population in the South Asian region is rapidly growing, prompting a rising need to understand the subjective mental wellbeing of older adults. Aging and life satisfaction are complex processes that are experienced differently in various sociocultural contexts. However, few studies have investigated mechanisms of life satisfaction in rural environments in low- and middle-income countries that face challenges that cannot be measured by existing metrics of mental wellbeing. The purpose of this study is to understand meanings of life satisfaction and experiences of aging through the perspectives of older adults who live in Jumla, Nepal. We conducted semi-structured, in-depth interviews with twenty older adults. Through thematic data analysis, guided by an interpretive phenomenological approach, we examined cultural shifts in caregiving and perceptions of family relationships in the aftermath of youth out-migration. Jumli older adults struggled to thrive as they navigated filial discrepancies amid migration and a changing economic context. However, older adults expressed a desire for their children to succeed. Many older adults sought to embrace changes in the economic and social landscape but struggled to thrive within these systems. Finally, adults connected their low life satisfaction with political and religious dynamics and tradition often helped them cope with situations that were outside of their control. Future research should address life satisfaction in rural contexts that may not fit into extant metrics of life satisfaction in older adults.