In an extreme example of angst over expensive medical bills, an elderly Washington couple who lived near the U.S.-Canadian border died in a murder-suicide this week after leaving notes that detailed concerns about paying for medical care, police say.

The Whatcom County Sheriff’s Office reported that deputies found notes in the couple’s Ferndale, Washington, home that explained the wife’s severe medical issues and “concerns that the couple did not have sufficient resources to pay for medical care.”

Deputies say Brian S. Jones, 77, shot and killed Patricia A. Whitney-Jones, 76, before taking his own life.

Police said the husband called 911 moments before 8:30 a.m. Wednesday and told the dispatcher of his plans to shoot himself. He said he wrote a note with instructions and told the dispatcher that the couple would be in the front bedroom.

The dispatcher tried to keep him on the phone, but he hung up.

Deputies responded to the house about 15 minutes later and a crisis negotiator tried to call the couple, first by phone, then a megaphone. When no one answered, deputies sent a robot-mounted camera in the house and discovered the couple.

Whatcom County Sheriff Bill Elfo said the tragic circumstances might have been averted if the couple had reached out for help.

“They think it’s the only way out,” Elfo told USA TODAY. “That just shouldn’t be in this country. There should be a much better way of responding to that.”

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Elfo said the medical examiner has confirmed the murder-suicide but investigators have not yet reviewed all paperwork, including the couple’s medical bills.

“We believe it is legitimate,” he said of the husband's angst over medical bills. “We certainly want to help and intervene and help the people get to a better day. When things peak like this, perhaps if they wait an hour or two, they can find a better solution then committing a murder and a suicide.”

Records show when the couple filed for bankruptcy in 2016, they estimated medical expenses of $200 and more than $122,000 in unsecured credit cards, credit accounts and collections.

Credit counselors say that people who struggle with hospital, doctor and prescription drug expenses often depend on credit accounts to pay medical bills.

Bruce McClary is vice president of communications for the National Foundation for Credit Counseling, a nonprofit financial counseling organization.

McClary said he consulted with seniors who would routinely resort to high interest rate credit cards to pay for expensive medical bills and prescriptions they could not afford. He tried to connect seniors with resources from patient-assistance organizations that help defray the cost of prescription drugs.

"It was just driving them further and further into debt that they otherwise would have been able to avoid had they found these resources sooner," McClary said. "That is one thing that is driving a lot of people to file bankruptcy in that age group."