The biggest influence in our community is our large elderly population, with an extremely extensive list of medications. The average geriatric patient in my community typically prescribes 15 to 20 different medications. From this course I discovered that this polypharmacy is actually a norm for the elderly population and not specific to my community. As a practicing nurse, I would like to analyze the use of polypharmacy in older adults with evidence-based practice. I believe there is a problem with the use of polypharmacy in the geriatric population, but at the same time there needs to be a balance because medications have increased our longevity over generations. Another cultural norm in my community is the lack of acceptance of Western medications, especially those living in the rural areas of the Appalachian Mountains. This culture believes more in folk medicine and often does not even receive healthcare except in cases of acute illnesses. As an APRN I will need to be aware of these cultural norms, especially in areas such as medication adherence and follow-up