Healthcare Needs of Senior Citizens in Upper Mustang, Nepal: A Cross-Sectional Descriptive Field Study

Introduction: Nepal's older population (aged ≥65 years) represents 6.9% of the national total and is growing rapidly. In remote rural areas such as Lomanthang Rural Municipality (R.M.) in Upper Mustang — an isolated high-altitude community at 3,800 m above sea level — the older prevalence reaches 13.1%, yet health and social support infrastructure remains critically insufficient. No previous study has systematically assessed the care needs of senior citizens in this community.

Methods: A cross-sectional descriptive field study was conducted in Lomanthang R.M. between May and September 2025. 187 senior citizens were visited at home and interviewed individually using a structured, context-specific questionnaire covering demographic characteristics, living conditions, activities of daily living (ADL), disability, chronic illness, nutrition, and socio-emotional well-being. Blood pressure and upper arm circumference were measured objectively. Data were analysed using descriptive statistics. Qualitative socio-emotional responses were analysed thematically using NVivo 15 software.

Results: All 187 eligible seniors were surveyed (45% male, 55% female; mean age 75.5 years). Most (87.2%) were illiterate. Thirty-eight percent lived without any family member present. Fourteen (7.5%) were dependent on family for ADL and 11 (5.9%) presented with suspected cognitive impairment (identified by family informants). Sixteen (8.5%) had significantly elevated blood pressure, most previously undiagnosed. Suspected malnutrition (arm circumference <21 cm) was found in 11 seniors (5.9%). Heavy alcohol dependence was identified in 8 individuals (4.3%). Overall, 38 seniors (20.2%) were classified as requiring professional care support.

Conclusions: This study provides the first comprehensive assessment of health and social care needs among senior citizens in Lomanthang R.M. Female Community Health Volunteers (FCHVs), already integrated into Nepal's national health system, represent a feasible and cost-effective mechanism for older care delivery in this remote setting. The project Senior Citizen Care (SCC) model is scalable and may be replicated in other remote Nepalese communities.

Keywords: senior citizen; caregiver; older care; activities of daily living; quality of life; female community health volunteers; Upper Mustang