GOULDSBORO — Patti McCartney left work Thanksgiving morning with holiday plans on her mind, like most people.

After her usual night shift at an Ellsworth nursing home, where she’s a certified nursing assistant, McCartney stopped to buy a pack of cigarettes and drove on to visit her mother and stepfather, as she did every morning.

Virginia and Raymond Hutchins had celebrated their 22nd wedding anniversary two days earlier and were hosting a holiday dinner for the family that afternoon. McCartney was looking forward to spending time with loved ones and having a day off from cooking.

She entered their neat clapboard Cape, next door to her own home in the woods off Grand Marsh Bay Road, and found her parents sitting side by side on the couch, a .22-caliber handgun beside them. Her mother – everybody called her Ginger – had been dead for some time. Her stepfather – she called him Dad – was still breathing. She dialed 911. It was a futile call.

Raymond Hutchins, 65, shot his 75-year-old wife in the head, then did the same to himself, state police investigators concluded. She had suffered from painful and degenerative arthritis throughout her body for several years. He was her primary caregiver – a Vietnam veteran who had his own health problems after being exposed to the chemical defoliant Agent Orange during the war.

“She had to have begged him to do it,” McCartney said, days after her parents died. “He wouldn’t have just done it. And he had to love her enough to do it and then take his own life. He said he would always be with her, no matter what.”

Family members describe the deaths of Ginger and Ray Hutchins as the tragic end to a wonderful romance between two private and proud people. They didn’t want strangers meddling in their lives, not even well-meaning home health aides.

Friends, former co-workers and others in the constellation of villages that make up the rural, seaside town of Gouldsboro, a less-touristy peninsula just east of Bar Harbor, say the couple’s violent, desperate end is sad but understandable, even acceptable, under the circumstances. Some say it was a merciful or compassionate killing.

“There should be a mercy pill so people don’t have to go through that,” said Deb VanLieu, bartender at The Pickled Wrinkle pub in Birch Harbor.

“Until you have been in that situation, caring for a loved one who’s in excruciating pain, you have no concept of what it’s like,” said Robert Webber, another Gouldsboro resident who had lunch at The Pickled Wrinkle.

“Maybe there were things that could have been done to help them, but some people don’t want someone messing around,” Webber said. “If they don’t want it, I think most of us would say it’s their life, stay out of it.”

Experts on elderly suicide vehemently disagree, saying that such views smack of ageism and pose a growing ethical challenge in a state and a nation with a rapidly increasing senior population. They say there’s an advancing imperative to make sure family members and friends know the warning signs of elderly suicide and the support services available to help people cope and even thrive in their later years.

“It’s never OK to take someone’s life and I have difficulty with those who think it’s an understandable or acceptable path,” said Lenard Kaye, Ph.D., director of the University of Maine Center on Aging in Bangor.

“There’s an acceptance in our society that there’s little life ahead of them and little reason to continue living,” Kaye said. “That is wrong. The system failed. To say nothing could have been done to ease their suffering is incorrect.”

ALWAYS IN SYNC

Ginger and Ray Hutchins met in 1981, when he operated the Winter Harbor Garage and she brought her car in for service. She was a Queens, New York, native and a divorced mother of two who had moved to the remote Maine fishing community with her first husband. Ray was a Marine veteran from North Carolina who, like many people in the area, had worked at the former naval base in Gouldsboro.

“They hit it off right away,” Patti McCartney said. “He wanted to get married but she wouldn’t at first. They moved in together and he kept asking her. Finally, she said yes.”

They got married on Nov. 25, 1992. Ginger was outgoing, kind and loved to read. He was quiet – a big teddy bear who could size people up pretty well and was uncommonly lucky at scratch tickets. They made a great pair.

“They had the kind of relationship everyone would love to have,” said McCartney, 54. “They were in sync all the time. They laughed a lot. They had fun together.”

Like many Mainers, Ray Hutchins was a hunter and handyman who built their house on Grand Marsh Bay Road. He and Ginger enjoyed watching the birds and other wildlife that visited their yard and lived in the woods outside Prospect Harbor.

“They both loved animals, so he wasn’t a very good hunter,” McCartney said. “He’d go out, but he wouldn’t get a deer. It’s hard when you see them in your yard every day.”

By the mid-1980s, Ray Hutchins was operating a pawnshop, then opened The Cat’s Paw pub in Birch Harbor. Today, it’s The Pickled Wrinkle, where some customers still remember him, including Lawrence Cowperthwaite, a lobster fisherman who considered Hutchins his friend.

“He run the bar pretty much by himself, from open to close,” said Cowperthwaite, downing a shot of peppermint schnapps. “It doesn’t surprise me that he shot himself. He was the type of guy that could do it. I think they sat down and talked about it, even planned it.”

MOUNTING HEALTH PROBLEMS

Before retiring several years ago, Ginger Hutchins worked for more than a decade as an education technician in Gouldsboro’s elementary schools. She loved children and helping them learn. But by the time her position was eliminated because of budget cuts, mounting health problems had begun to take a toll. She spent her last year at the relatively new Peninsula School, which serves about 185 students in a town of more than 1,700.

“Her last day here was very sad for Ginger,” said Susan Tenan, a third-grade teacher who worked with her. “I remember she had a little cry and we had a talk about it.”

By then Ginger could no longer drive and walked with a cane. She had fallen at school one day, and while she wasn’t hurt, she was mortified. She spoke openly about her loving husband and the health challenges they faced together.

“You could see the pain in her face,” said Rosalie Mitchell, a fellow ed tech who often gave Ginger rides to and from work. “She was on some heavy (pain medication), but it just wasn’t working. She had two back surgeries and had steel rods put in. The last one she was hoping to get some relief, but she said it made it worse.”

She told Mitchell that her husband also had multiple surgeries, for cancer and other problems that left him blind in one eye and without a few toes. The last time Mitchell saw Ginger Hutchins, about two years ago, she had grown frail and was toting a portable oxygen tank to combat chronic obstructive pulmonary disease. She struggled to breathe.

“I was sad when I learned about their deaths, but I wasn’t surprised,” Mitchell said. “She told me, ‘Nobody realizes the pain I’m in.’ She said she didn’t know how long she could keep living like that and she didn’t like people taking care of her.”

INCREASING ISOLATION

Patti McCartney is adamant that nothing more could have been done for her parents. They were independent people who didn’t want outside help. Neither of them. Even in recent years, when Ginger Hutchins rarely ventured out and needed help bathing and getting to the commode.

“He was her husband and he was going to take care of her,” McCartney said. “He didn’t want strangers in the house and she didn’t want people seeing her the way she was. The only people who went in the house were family and whenever Dad went anywhere, he made sure I was with her so she was never alone. Never alone.”

McCartney believes her mother’s retirement triggered her rapid decline. Experts would likely agree. They say two things lead older adults to consider suicide: the perception that they are no longer a contributing member of their family or community, and the belief that they have become a burden.

Coupled with their own physical and mental pain and suffering, and the fact that our society celebrates youth and abhors illness, it’s no surprise that suicide accounted for 15 of every 100,000 deaths among Americans age 65 and older in 2011.

That’s higher than the rate among 15- to 24-year-olds, which was nearly 13 of every 100,000 deaths that year, according to Patrick Arbore, Ed.D., founder and director of the Center for Elderly Suicide Prevention at the Institute on Aging in San Francisco.

“The worst thing to be in America today is old,” Arbore said. “And there’s nothing more feared by healthy people than sick people. If we continue to think this way, we’re going to face a growing problem.”

WARNING SIGNS

Arbore and other experts say family members and friends must look for signs of trouble when elders become ill and isolated. Moreover, they warn that the potential for murder-suicide rises when men are thrust into the role of long-term caregiver – something few people are prepared for but is especially difficult for most men.

“Be very, very thoughtful (if it’s) the female spouse that develops health problems,” Arbore said.

That’s because men are four times more likely to die by suicide than women, and men age 65 and older are 12 times more likely to die by suicide than elderly women, Arbore said. Chances grow if there are guns in the house and the man is a veteran who was trained to kill under pressure, he said.

Typically it’s the dominant spouse – often the husband – who suggests and promotes the idea of murder-suicide, said Kaye, of the UMaine Center on Aging. Women who have faced such an untenable proposal said they agreed with their husbands to hush their concerns but never thought they would actually do it, Arbore said.

In fact, of 27 domestic murder-suicides in Maine since 2005 – an average of three per year – six involved elderly couples, and each of them was carried out by the husband, according to data provided by Stephen McCausland, spokesman for the Maine Department of Public Safety.

In Skowhegan in 2011, 86-year-old Barbour Flewellen called 911 to report “two mercy killings,” then shot his 75-year-old wife, Marie, and himself upstairs in their bed. In Carmel the same year, 74-year-old Laurel Johnson shot and killed his 69-year-old wife, Patricia, then turned the gun on himself. They were found by family members and a hospice worker who had been visiting Patricia daily.

In most cases, seniors who consider suicide are facing growing social isolation and dependency because of mounting illness and disability, said Dr. Clifford Singer, head of the Geriatric Mental Health and Neuropsychiatry Program at Acadia Hospital in Bangor.

Common issues that can trigger depression and thoughts of suicide include the loss of mobility, vision and cognitive function and increasing chronic pain, Singer said. A thorough geriatric assessment by a primary care physician or other professional caregiver can flag critical problems for enhanced treatment, better pain management or outside support.

Maine’s area agencies on aging provide training and support for family caregivers, and home health and hospice workers can lessen the burden on caregivers. They also can help provide palliative care, which can reduce or eliminate disabling symptoms.

“In the midst of severe pain or suffering, it is often difficult to see that there are possibilities for relief,” said Dr. Elizabeth Hart, medical director of MaineGeneral Hospice. “But I do believe that with the support of additional services, both the caregiver’s burden and (the spouse’s) suffering may be lessened.”

BEST FRIENDS

The day before Ginger and Ray Hutchins died, she fell and wound up in the local emergency room. She had no visible injuries, her daughter said, but when the doctor on duty asked her to rate her pain level from 1 to 10, she said it was 12.

The doctor gave her additional pain medication and sent the couple home. The next morning they were dead, leaving behind their daughter, three grandchildren and five great-grandchildren. They left no note and never disclosed a murder-suicide plan, McCartney said, but they often told people that if one of them died, the other wouldn’t be far behind.

“That’s what they wanted to do. You can’t be judgmental about it,” McCartney said. “I don’t know what they were thinking. I don’t know what set it off. We never will.”

McCartney knows some people blame her for not being there to stop her stepfather. She has seen cruel reader comments posted on news stories that she’s read online.

“Those people don’t know me,” she said. “They weren’t there.”

McCartney returned to Maine seven years ago to help her stepfather take care of her mother. She left behind a house and a convenience store manager’s job in Washington state that she loved. She bought the house next door to her parents, where she lives with her teenage son and her husband, Ken, an emergency medical technician.

She worked nights so she could visit her parents several times a day and stay with her mother whenever her stepfather had medical appointments. She would have taken care of her mother full time, she said, but she couldn’t afford to give up her CNA job.

“I was there when they needed me,” she said. “It was all I could do.”

McCartney said she’s more hurt than angry at her stepfather. She figures he did what he had to do. But she misses her mom. She was her best friend. There are moments when she imagines that her parents still might walk through the kitchen door. Then she remembers they’re gone.

“I really haven’t dealt with it yet,” she said. “I know when I slow down, it will hit me, but I’ll get through it.”