I'm a domicilary carer (and asthmatic) with an 86 year old client who has recently been prescribed an Ivax Easi-breathe (salamol). She can't use a metered dose inhaler as arthritis means she cant push down on the canister, so that rules out spacers too. Shas COPD and finds it difficult to breath in deeply. I'm not sure she is getting much of the medication in using this device. While being treated in hospital for pneumonia last year she recalls having a once a day nebuliser. Does anyone know if there are long acting relievers that can be taken this way? With carers visiting daily they would be able to assist her with a once (or twice) a day nebuliser but not 4 hourly. PS She already takes oral steroids for the rheumatoid arthritis which is, I presume, why she has not been prescribed an inhaler corticosteroid just a reliever.