Various frameworks related to climate change and adaptations that have been developed to date have notable benefits as well as significant limitations. It is not always practical to implement advanced climate change frameworks in situations with limited data availability. Social aspects, such as people’s experience and perception, are often under-prioritized. Therefore, this study introduces an integrated framework linking social and physical aspects of climate change to assess its impacts on water resources and to evaluate differing adaptation options in poorly gauged basins. A case study of the Kali Gandaki River Basin (KGRB) in western Nepal is presented to demonstrate the applicability of this framework. Results of the study show that people of the mountainous Mustang district in the KGRB have perceived climate change or climate variability, its impacts on water resources, as well as other water-related issues and potential adaptations or responses. Furthermore, evaluation of people’s perception using available physical data confirms the increase in temperature and average annual discharge in the Kali Gandaki River as well as poor water use, as a major problem at all levels in the basin. Despite increasing water availability, a concurrent increase in water use is difficult due to topographic constraints on irrigation development. However, the impacts of climate change are particularly severe in Mustang, owing to the fact that a large proportion of the population depends on a climate-sensitive livelihood like agriculture. Therefore, various adaptation options are identified in the agricultural sector, and one relevant option is further evaluated. The framework developed in this study has the potential to be further applied to other poorly gauged basins.