The greatest influence in our community is our large elderly population, with an extremely long medication list. The average geriatric patient in my community typically prescribes about 15 to 20 different medications. I discovered through this course that this polypharmacy is actually a norm for the elderly population and not specific to my community. As a nurse practitioner, I would like to analyze the use of polypharmacy in older adults with evidence-based practice. I think 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 rural Appalachia. This culture believes in more folk medicine and often does not even receive health care unless there is an acute illness. As an APRN, I will need to be aware of these cultural norms, particularly in areas such as medication adherence and monitoring.