Updated

A dispute over whether a terminally ill woman should have been given tea and toast or an orange apparently upset her husband so much that he shot and killed two of her sisters and his son before killing himself, a sheriff said Tuesday.

The sick woman, 59-year-old Darlene Gilkey, who's dying of cancer, witnessed the shootings from a hospital bed in her living room but was uninjured, Hocking County Sheriff Lanny North said.

The woman's son, Ralph Sowers III, told a 911 dispatcher he survived when his stepfather, Paul Gilkey, said he was sparing him because he had kids. Sowers said his stepfather repeatedly warned him to get out of the way before putting the gun above his head and shooting his brother, who was hiding behind him.

After the shootings Monday, Paul Gilkey, 63, stepped out onto his front porch, sat down in a chair and shot himself to death, the sheriff said.

Killed inside the home were Darlene Gilkey's sisters, Barbara Mohler, 70, of New Straitsville, and Dorothy Cherry, 63, of New Plymouth. Also killed was Paul Gilkey's son, Leroy Gilkey, 38, of Columbus.

Paul Gilkey, who went by his middle name, Dave, was stressed and upset as he tried his best to care for his wife, whose cancer was diagnosed around Thanksgiving right after an injury at a local hospital where she worked, said his sister-in-law Peggy Gilkey, the wife of his brother Gary Gilkey.

Paul Gilkey felt as if other members of his wife's family were taking over the care, and he was upset by the number of people in the house and the fact that things were already being taken out of the house in southeastern Ohio, Peggy Gilkey said.

Investigators say Leroy Gilkey had power of attorney over his mother, a fact that added to Paul Gilkey's stress, according to Peggy Gilkey.

"He felt like that they were pushing him out and trying to take over," Peggy Gilkey said Tuesday.

She added: "He was really trying to take care of her, but he felt like people weren't letting him."

She said Paul Gilkey and her husband talked several times a week about the situation.

She said her brother-in-law probably let his wife live because he loved her so much. The couple had divorced in 1975, shortly after he went to prison for a 1974 murder, but remarried a few years ago, she said.

North, the sheriff, said events leading to the shootings began earlier in the day when some of the victims had apparently served Darlene Gilkey tea and toast after Paul Gilkey had already peeled an orange for her. He said that led to an argument that escalated and culminated in the shootings.

"It sounds like it was over her well-being, her care," the sheriff said.

As the argument heated up, Paul Gilkey left the living room, went to a bedroom to retrieve a gun, returned to the living room and started shooting, authorities say.

The sheriff said Gilkey shot Mohler first, then ordered Sowers to leave. He said Gilkey then shot his son and again ordered Sowers to leave, before shooting Cherry.

Hocking County coroner David Cummin said eight or nine gunshots were fired during what autopsies confirm was a triple homicide followed by the assailant's suicide.

He said Mohler died from two close-range gunshot wounds to the head and Leroy Gilkey was killed next with three close-range gunshot wounds to the head. Cherry then suffered a gunshot wound to the chest from an undetermined distance and a close-range gunshot wound to the head.

Paul Gilkey shot himself in the chest.

Cummin said Leroy Gilkey also had a possible fourth injury that penetrated his right hand.

Mohler had been employed for more than a decade at the Walmart in Logan, where she worked in the bakery, Walmart spokeswoman Ashley Hardie said. Employees there were grieving and extending their condolences to Mohler's loved ones Tuesday, Hardie said.

A sobbing Sowers described in a nearly hour-long 911 call how Paul Gilkey shot his son, Sowers' brother, after repeatedly warning Sowers to duck.

"He tried to shoot my brother, and my brother was hiding behind me. And then he kept telling me to 'Duck! Duck! Duck!'" Sowers said on the call.

Then Paul Gilkey "walked up to me and held the gun over my head and squeezed the trigger, and my brother went down on the ground," Sowers said. "And then he walked over to my aunt and shot her."

Sowers, 36, fled the house and drove up the road seeking a cellphone signal to call for help.

"He let me leave because I have kids," Sowers says on the 911 call.

After Gilkey shot himself, his body stayed upright, and in the darkness police couldn't tell if he was alive, North said. That led to concerns about a hostage situation, although that wasn't the case.

Deputies who stormed the home around 9 p.m. found Paul Gilkey dead on the front porch and the three other bodies on the living room floor, North said.

The house sits at the end of a gravel lane amid rolling, wooded hills dotted with farmland near Logan, 50 miles southeast of Columbus.

Paul Gilkey served a decade in prison beginning in 1974 for killing a man in Athens County in May of that year, according to court records. He also had a 1986 arrest for felonious assault, according to the Hocking County sheriff. He had not worked for several years because of a workplace injury, Peggy Gilkey said.

Darlene Gilkey was receiving hospice care through a company in nearby Lancaster, whose chief executive declined to comment Tuesday because of privacy restrictions.

A cousin of Paul Gilkey said Gilkey was upset about other family members being in the house.

"They — the two sisters and his son — were staying out there, and he said he couldn't spend any time with her," said Matthew Henderson.

Henderson said his own wife happened to call the home immediately after the shooting and spoke with Darlene Gilkey, who said that her 63-year-old husband "shot everybody" and then went outside.

"I said, 'What's he doing?' (She said) 'I think he's waiting on more people to come so he could kill them,'" Henderson recounted.

The wife didn't say why she'd been spared, Henderson said.

"I think he thought if he would kill her he would go to hell," he said.

Henderson said his cousin had recently bought two or three plots at a cemetery, though it didn't seem unusual for a man whose wife had terminal cancer. He described Paul Gilkey as unpredictable and unstable.

"I thought what would happen is that he would wait until she passed away and then he would shoot himself," he said. "I didn't think he would shoot other people."

Leroy Gilkey was a high school Spanish teacher in the Westerville school district in suburban Columbus.

Gilkey was "a very well loved and well respected teacher among students, among his colleagues and among the families that send their children to Westerville North (High School)," school district spokesman Greg Viebranz said.

Neighbors were shocked by the bloodshed. John Poling, who lives about a quarter-mile down the road, said he didn't know the couple but believed they had moved into their home within the past 10 years. He said he watched from a distance Monday night as law enforcement and SWAT officers closed in.

North said the county is normally "pretty quiet."

"We have a few major crimes occasionally," he said, "but nothing of this magnitude."

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Associated Press writers Andrew Welsh-Huggins, Doug Whiteman and JoAnne Viviano in Columbus and AP News Researcher Julie Reed in Charlotte, N.C., contributed to this report.

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Kantele Franko can be reached at http://www.twitter.com/kantele10

Andrew Welsh-Huggins can be reached at http://twitter.com/awhcolumbus