A/HRC/30/43 15. Whereas older persons are often seen as a homogeneous group, this group is in fact the most heterogeneous of all age groups. Some persons may be in good health and may be able to live independently or autonomously throughout their lives; but others will become increasingly dependent on the help of others in old age for several reasons—such as illness, impairments or loss of mobility—and may require varying degrees of specific care. 16. Ensuring that older persons are in a position to lead autonomous lives to the greatest extent possible—irrespective of their physical, mental and other conditions—requires a radical change in the way society perceives ageing. There is a need to foster age-sensitive communities and age-friendly environments to help older persons retain their autonomy and be active, and be integrated effectively in all aspects of life. 17. It is therefore essential to move away from a needs-based and biomedical approach that focuses on disease and functional dependency to an all-encompassing human rightsbased approach in which the enjoyment of all human rights by older persons becomes an integral part of all policies and programmes affecting them, including care planning and delivery. 18. Ageist attitudes still persist throughout the world, leading to discriminatory practices towards older persons, including in care settings. Age-based discrimination generates a lack of self-esteem and disempowerment, and undermines an older person’s perception of autonomy. This is particularly true when they are in need of care to maintain or regain autonomy. A. 1. Legal framework Autonomy 19. Autonomy is a core principle of the Convention on the Rights of Persons with Disabilities. Even though ageing should not be associated with disability, this legal framework could be applied to older persons with disabilities and could provide guidance on the scope of the concept of autonomy. 20. The Convention, in its preamble, recognizes the importance for persons with disabilities to have their individual autonomy and independence, including the freedom to make their own choices. Article 3 (a) refers to respect for inherent dignity and individual autonomy, including the freedom to make one’s own choices, and the independence of persons. 21. The Convention also refers to autonomy in relation to health care and recovery from violence or abuse. Article 25 (b) requires that health services be designed to minimize and prevent further disabilities, including among children and older persons. Article 19 provides further guidance on measures that should be adopted to facilitate independent living and the full inclusion and participation of older persons with disabilities in the community. 22. The United Nations Principles for Older Persons refer to the principle of independence to describe the importance for older persons to have access to adequate food, water, shelter, clothing and health care, through the provision of income, family and community support and self-help. Older persons should also have the opportunity to find remunerated work or have access to education and training to allow them to live independently. 23. In accordance with the Principles, participation is to be understood as ensuring that older persons are actively involved in formulating and implementing policies that affect their well-being, sharing their knowledge and skills with younger generations, and being able to form movements and associations. 24. The section on self-fulfilment foresees that older persons should be able to pursue opportunities for their full development through having access to the educational, cultural, 5