MADISON — Just weeks before J. William “Bill’’ Walker killed his wife, Carolyn and himself, he told his sister-in-law that he planned to find an assisted living center where he and his ailing spouse of 30 years could remain together.

But something overtook reason in the mind of the doting husband on Monday afternoon.

And live-in caregiver Pauline Lowe Tucker of Madison bore witness to the tragedy, spared by Walker, 86, after he briefly pointed a pistol at her. She would recount the ordeal to police at the crime scene as they documented what officials said was the 202-year-old town’s first murder-suicide.

After asking Tucker to place his wife in her bed around 3:30 p.m., the retired dentist walked into the bedroom of the couple’s gray frame, two-story home at 304 W. Decatur St. and shot his wife twice in the center torso, according to Tucker’s account and police.

Walker then turned the silver revolver on himself and fired two more rounds into his own chest, Madison Police Chief Mike Rutherford said, describing Walker’s weapon as either a .357- or .45-caliber firearm.

Carolyn Moseley Walker, 86, described by her relatives as vibrant and accomplished, had long suffered from a serious heart condition and had developed advanced Alzheimer’s.

“I choose to believe something had happened with him — maybe with his health — and he felt he was doing the best thing he could. That’s what I’m going to hope,’’ said Maegan Walker, the great-niece of Carolyn Walker, and no blood relation to her great-uncle, whom she fondly called “Bill-Bill.’’

“He didn’t indicate to us that anything was wrong,’’ Walker said by phone Wednesday from Gaffney, S.C. “He had been diagnosed with cancer a couple of years ago and was a lifelong smoker, so I don’t know if the prognosis had changed or something. But he was so gentle and loving toward (Carolyn). That’s why this comes as such a shock.’’ The dentist’s cancer diagnosis was an error, however, said one of his Rockingham County relatives.

For people over 55, issues of declining health and the threat of separation from a spouse are known to precipitate murder-suicides, according to psychologist Joni E. Johnston, an expert who wrote about the phenomenon in the March 29 issue of Psychology Today.

And in the United States, an average of 11 murder-suicides are reported each week, though the crimes account for only 5% of the nation’s annual reported homicides, statistics show.

Indeed, psychologists describe a “recipe” for murder-suicides that tend to be perpetrated by older white males. Research shows that such criminal behavior is triggered when men feel the threat of loss or separation from a loved one or when one or both spouses suffer from a preexisting medical condition.

But even the night before the tragedy, nothing seemed amiss, Walker’s in-laws said.

Carolyn Walker’s sister, Mary Moseley Sellars of Gaffney, spoke by phone with her Sunday night, Maegan Walker explained. “They talked … every night, and my grandmother didn’t pick up on anything out of the ordinary.’’

Sellars, an able-bodied and independent 87-year-old, had also made past offers to have her sister live with her full time in Gaffney. But the Walkers declined, their great-niece said.

Career woman and ‘Mrs. Claus’

A generous and vivacious woman, Carolyn Walker grew up in Gaffney and moved to Charleston, S.C., after high school where she landed a job as an executive secretary to the president of Carolina Shipping Co. After moving to Louisiana several years later, she became head of the human resources department for ExxonMobil in Baton Rouge.

“She was extremely intelligent,’’ Maegan Walker said of her great-aunt. And while she did not have children of her own, Walker was a steady presence in the lives of her great-nieces and great-nephew. “She was like a second grandmother to us — just amazing.’’

In fact, most every Christmas, Bill and Carolyn Walker loaded two large cars with gifts and Short Sugar’s pit-cooked barbecue from Reidsville and headed down to Gaffney to delight Carolyn’s extended family.

“It was always so wonderful when we were all together — not just the presents, but being together. She taught us card games and she was always so sincere and outgoing, and she always made homemade cheese crackers and fudge,’’ Maegan Walker said.

Her spirited great-aunt had chronic health struggles, though, Walker said. “Every few years we would get a call that she was in the hospital for her heart. She had several surgeries and a pacemaker. She hadn’t been able to drive in 15 years,’’ Walker said.

Walker was generous with wife

Still shocked and awaiting her great-aunt’s autopsy report, Walker said the Bill Walker she knew was terrific.

He was a man who rushed to help his wife when she needed a boost to her feet — the gentleman who chose exquisite jewelry for his wife and saw to it that she had top-of-the-line cars, fine clothes and a second house at Myrtle Beach.

“As a couple they were just so loving. He doted on her and wanted her to have the best of everything,’’ Walker said. “I loved them both so much.’’

Stress and access to weapons facilitate suicide

A build-up of intense stress and access to lethal weapons can increase the incidence of suicide, said Susan Robinson of Raleigh, North Carolina’s suicide prevention coordinator and state coordinator for Hope4NC, a crisis counseling services assistance training program within the N.C. Department of Health and Human Services.

“Death by suicide generally isn’t because of one or two things, but because of a series of things over time,’’ Robinson said during a Wednesday phone interview. “Certain stressors may come to the top’’ as a focus of someone’s emotions, Robinson said, noting that the COVID-19 pandemic has the potential to compound stress and anxiety.

Feeling blocked from a solution drives some people to end their lives, Robinson said.

“Most people do not want to die, but don’t see a way through,’’ she said, explaining how vital it is that people with thoughts about committing suicide reach out for help from family, doctors and numerous local, state and national hotlines.

Robinson hopes for a time when questions about suicide will become routine during general medical exams. “Often, it takes just five minutes to save a life’’ through mental health support, she said.

In Walker’s case, “there was a place where he didn’t see a way through. We want everyone to find a place of hope.”

No funeral arrangements for the Walkers have been announced.

Susie C. Spear is a staff writer for RockinghamNow. She can be reached at 743-333-4101 and on Twitter @SusieSpear_RCN.

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