I was flipping through mind-numbing programming and stopped to watch House for a few minutes. If you have never heard of it the show focuses on the demented, crippled, and pain-killer addicted doctor House as he fumbles his way through "mystery" illnesses and tortures his medical team as much as possible.
There was a scene where Dr. House is seeing clinic patients and he has a female patient who says she is using one inhaler a week and her breathing is not getting any better. He asked her if she knew how to use her inhaler and she replies "Do I look like an idiot?" He says she does not but asks her to demonstrate how she is using the inhaler. The lady sprays it on the left and right sides of her neck like perfume. I almost wet myself I was laughing so hard. It was a wonderful laugh at an unfortunately common problem: inhaler misuse.
Please do not assume that telling a patient how to use the inhaler ensures that they will actually use the inhaler properly. This includes discharge from the emergency room because an even more common problem is that a patient will say they weren't told anything at the hospital when I know for a fact the nurse discharging the patient goes through all the paperwork with them including medication use.
Make the patient go through the motions as you describe it to them then discuss the medication, see if they have any questions or concerns, then have them demonstrate again how they are going to use the inhaler. This may not ensure proper use but it is the best we can do even with instructions in the inhaler packaging.
If there is anything the medical world teaches you is that most people have no common sense. This leads the U.S. government to over regulate things that are available without a prescription in other countries. Basically, most Americans are idiots, including the ones in power. It is with shame I hang my head and seek a mail-order husband from another country...