An elderly couple who died by murder-suicide in the state of Washington Wednesday left notes for police explaining that they were worried about medical bills. Law enforcement officials say Brian S. Jones, 77, shot and killed Patricia A. Whitney-Jones, 76, before turning the gun on himself.

The Whatcom County Sheriff’s Office published a detailed report of the murder-suicide on its Facebook page, noting they received a 911 call from the 77-year-old man saying he was going to kill himself, detailing how he left a note with instructions. The dispatcher tried to keep him on the phone but the man hung up. When police arrived, the couple was already dead.

“Several notes were left citing severe ongoing medical problems with the wife and expressing concerns that the couple did not have sufficient resources to pay for medical care,” notes the Whatcom County Sheriff’s Office.

“They think it’s the only way out,” Whatcom County Sheriff Bill Elfo said. “That just shouldn’t be in this country. There should be a much better way of responding to that.” Although the medical examiner has confirmed this was a murder-suicide, investigators haven’t yet been able to review all the paperwork and claims of high medical expenses. But records show the couple filed for bankruptcy in 2016 with a lot of outstanding credit card debt. Experts say senior citizens often have to resort to using high-interest credit cards for expensive medical bills.