A/HRC/30/43 older persons with disabilities, and persons with chronic illnesses, non-communicable diseases and dementia. Gender, disability and cultural sensitivities should be promoted in care settings to allow older persons from different backgrounds to be informed effectively and to be able to make decisions. Specialized integrated social and health-care services should be developed and implemented to address dementia and other degenerative diseases that lead to dependency. IV. Conclusions and recommendations A. Conclusions 89. In the light of the intensity of ageing in many societies, there is a need to ensure that older persons are enabled to lead autonomous lives. This also calls for a paradigm shift that focuses on the inclusion of older persons in society at all levels, encompassing age-friendly communities and environments, as well as people-centred models of care, and that promotes the autonomy and dignity of older persons. 90. The design, implementation, monitoring and evaluation of any social and health-care legislation, policies, programmes, strategies and settings must take into account the respect for and the strengthening of older persons’ autonomy. To promote this autonomy, effective care for older persons needs to integrate economic, physical, mental, social, spiritual and environmental factors. 91. The increasing prevalence of chronic and degenerative diseases in older age poses challenges to the development and implementation of appropriate models of care for older persons. The disease-focused approach in care at different levels needs to be replaced by more effective and rights-based models in order to address the specific needs of the most heterogeneous of all age groups. B. Recommendations 92. With a view to assisting States in developing and implementing appropriate and effective measures to ensure the autonomy of older persons, including in social and health-care settings, the Independent Expert makes the recommendations set out below. Legal, institutional and policy framework 93. States must fully comply with their international obligations relating to autonomy and care. The Independent Expert strongly encourages States to ratify all the core human rights treaties, including the Convention on the Rights of Persons with Disabilities, as well as all relevant regional instruments —notably the recently adopted Inter-American Convention on the Human Rights of Older Persons, which makes explicit reference to autonomy and care. 94. States should design and implement effectively national policies and action plans on ageing that include specific provisions on autonomy and care, in a comprehensive and intersectoral manner. 95. States should establish national councils on ageing, with older persons among its members, to design and develop policies, including care, that correspond to their needs and respect their autonomy. Such councils should guarantee pluralism, represent the diversity of older persons and receive sufficient funding so that they can function properly and effectively. 16