A man killed his wife and himself at a St. Petersburg assisted living facility. Why?

Editor’s note: This story includes discussion of suicide. If you or someone you know is considering suicide, resources are available to help. Please see the information at the end of this story.

ST. PETERSBURG — Before he entered his wife’s room at an assisted living facility for the last time, Thomas Dowler put a pen to paper and started writing.

In the note, Dowler explained — as much as 61 words could — what he was going to do.

“It’s become obvious to me that Susan will never walk again or be able to stand on her own,” the note written on an Office Depot legal pad began. “I can’t stand to see her like this.”

The note said it was “time to move on” and that Tom Dowler had made the decision on his own to act, without anyone knowing.

Shortly after 9 a.m. on Jan. 23, Dowler, 81, walked into Addington Place armed with a snub-nosed revolver, according to a St. Petersburg Police Department report. His 76-year-old wife, Susan Dowler, had been there for about a month.

A nurse doing rounds found the Dowlers shortly after 10 a.m. She yelled for co-workers to call 911.

The couple’s family would have to reckon with the decision Tom Dowler carried out that morning to take his and his wife’s lives into his hands and, according to his note, unilaterally decide their fate.

Experts say the case bears similarities to other homicide-suicides among older people, incidents that often share identifiable patterns while at the same time sparking confounding questions that often go unanswered.

Tom and Susan Dowler “lived for each other” and had been happily married for more than 40 years, said Susan’s sister, Jennifer Chassee.

“I’m shocked that he did it because it’s not within his character, but he did hold a lot of things in,” Chassee said. “But I know he didn’t do it out of malice. Just in his mind, he thought this was the best way to handle it.”

An active marriage, then health problems

The second-oldest of five siblings, Susan Dowler was born in Michigan and mostly raised in Nashville, Tennessee.

Chassee described her sister as positive, upbeat and friendly.

“We always teased her because she was a Pollyanna,” the Virginia resident said in a phone interview. “She always saw the best in people, but she was strong.”

Before meeting Tom Dowler, Susan endured tragedy as a young mother when her 6-year-old son from a previous marriage was fatally struck by a car. The loss deepened Susan Dowler’s Buddhist faith, her sister said.

Susan and Tom met in Nashville through a mutual friend. Tom was an entrepreneur for most of his life and “quite successful,” Chassee said.

“I think it was his character, his charisma, his sense of humor” that drew her sister to him, she said.

Tom Dowler had three children from a prior marriage, and Chassee said Susan loved and treated them and their children like her own.

Tom Dowler’s son Todd Dowler said the family had no comment for this story.

The couple lived in the Nashville area for years. Susan Dowler worked in hospital administration and was an admitting coordinator for Centennial Medical Center when she retired.

The Dowlers traveled the world together. At one point, they took their powerboat, the Kay-Tee-Kay, from Michigan to Florida and lived on the vessel before buying a condo in St. Petersburg.

Property records show Tom Dowler bought a condo in the Isla Key complex on 54th Avenue South in St. Petersburg in 2002. Chassee said the couple became full-time Florida residents several years ago.

The Dowlers loved spending time with family and were part of a vibrant social scene at Isla Key. They shared meals with friends and played trivia. Susan played mahjong and joined a book club. Tom played golf.

Susan Dowler was diagnosed with multiple sclerosis in her late 50s or early 60s and had severe arthritis in her knees, her sister said. The morning after Thanksgiving last year, she was admitted to the hospital with severe pain. Doctors diagnosed her with diverticulitis, an inflammation of pouches that line the digestive system, and she underwent surgery. She was at Addington Place recovering from the procedure, Chassee said.

According to the police report, Susan Dowler arrived at Addington Place on Dec. 14.

The report says Susan Dowler was expected to be released and enter hospice care — the report doesn’t specify who provided investigators with that information — but Chassee doesn’t think that’s accurate. She kept in frequent touch with her sister, who never mentioned any plans for hospice care.

“She was up and about and she was sending notes every morning to all her friends,” Chassee said. “And even to the day that she passed, she was texting and saying ‘good morning, everyone, I’m doing well, I’m going to the doctor, getting my hair done,’ stuff like that.”

She talked to her sister the day before the shooting. Susan Dowler had a doctor appointment the next day and was hoping she’d get to go home in a couple of weeks.

During the call, Chassee overheard a nurse praising Susan for accomplishing a task on her own.

“I said, ‘Good job, low and slow,’ and the nurse goes, ‘It’s not a race, it’s a marathon,’ and I said, ‘Yep, she’s in it for the long haul,’ and Susan goes, ‘Yep, I am.’”

“She was going through physical therapy and was trying to get stronger,” Chassee said, “but I guess Tom just thought she was never going to be able to walk again and stand unassisted and he couldn’t bear seeing her like that and couldn’t bear thinking about life without her or her life without him.”

“I don’t do alone well”

Surveillance cameras at Addington Place captured Tom Dowler entering the elevator at 9:01 a.m. on that Tuesday in January, according to a police report. His wife was in Room 219.

Amber Campbell, a certified nursing assistant, told police that she usually took care of Susan Dowler but was not assigned to her that day. Campbell said the Dowlers seemed like a happy couple and that Tom Dowler would clean his wife’s wound and do other tasks that staff could have done.

Campbell said she saw Tom Dowler on the second floor that morning. She didn’t interact with him but said that he generally was friendly and always said hello. He usually came to visit his wife after lunch, so it was unusual for him to be there at that time, Campbell told police.

Nurse Mary Wildgoose first saw Susan Dowler at about 7:30 a.m. that day while making rounds, according to the report. They talked a little about the NFL playoffs, and Susan Dowler seemed to be in good spirits, Wildgoose said.

When Wildgoose entered the room about 10:10 a.m. to give Susan Dowler her medication, she saw blood under the bed and on her head. She walked to the bed and shook Susan’s foot and said her name, then saw Tom Dowler’s body on the floor near the bed. She ran out of the room, yelling for someone to call 911.

Dowler had shot his wife in the temple as she lay in bed, then shot himself in the head. The black Ruger LCR .38-caliber revolver was lying on the floor near his body.

Campbell and Wildgoose said they didn’t hear any gunshots. If other employees heard shots, it’s not mentioned in the report.

Police went to the couple’s condo in Isla Key, which is about a mile west of Addington Place. They found on the kitchen table the handwritten note along with paperwork and what the police report described as “instructions for family post death.”

Dowler said in the note that, along with his wife’s health issues, “my mobility has become difficult.”

“So it’s time to move on,” the note said. “This decision is mine alone and no one knows anything about it. It’s better for all involved. I don’t do alone well.”

Among the papers was a business card for a Michigan funeral home, noting that arrangements had already been made and paid for.

Details about the mobility issues Tom Dowler referenced in his note are unclear.

Common themes

The case bears similarities to other homicide-suicides among older people, said two experts who reviewed details at the Tampa Bay Times’ request.

The perpetrators in homicide-suicide cases among older people are almost always men, typically older than their victims, said Donna Cohen, a professor emeritus at the University of South Florida. Cohen said there are roughly 1,500 homicide-suicides each year in the United States and about 40% of them are among people 55 and older. They usually involve a husband and wife.

Cohen conducted a study of 116 cases of family caregiver homicides across the U.S. between 2010 and 2015. One finding was that about two-thirds of caregivers who killed their spouses subsequently killed themselves.

Cohen said it’s not uncommon for men to kill their partners and themselves because they’re acting on beliefs rather than facts. And men often fear being alone after their partner is gone.

“It’s not killing out of love,” Cohen said. “It’s killing to put an end to a situation that he can’t deal with.”

Generally, Cohen said, “women in these positions, when husbands are sick, seek help. Men have to do a task,” and sometimes, often due to depression and desperation, they decide on homicide-suicide.

In his 2014 book, “The Perversion of Virtue: Understanding Murder-Suicides,” Florida State University psychology professor Thomas Joiner argues that such cases always involve the misguided invocation of at least one of four virtues: mercy, justice, duty and glory.

Tom Dowler’s note indicates he was motivated by mercy and duty, Joiner said.

In his most recent book, “The Varieties of Suicidal Experience: A New Theory of Suicidal Violence,” Joiner posits that murder-suicide is better understood as motivated by suicidal impulses than by homicidal ones.

“People do this kind of thing when they think death is better than life, and also when they’re lonely,” Joiner said. Tom Dowler, he said, “checks both of those categories pretty well in just that one brief note.”

“These very often are not very accurate views, but the person doesn’t know from the inside that what they’re thinking is inaccurate,” Joiner said.

Cases like the Dowlers’ often leave surviving loved ones angry and confused. Cohen said it’s critical for stories like theirs to be told to raise awareness so that family members, friends and health care professionals can be on the lookout for warning signs.

“It’s important that you talk with them, ask if you can meet with their doctors, and ask if there’s anything you can do,” Cohen said.

Joiner also emphasized what’s known as “means safety” — taking precautions to eliminate possible ways that someone could use to kill themselves and others, such as securing firearms and medications.

Tina Solava, a spokesperson for Addington Place, said she could not comment specifically on the Dowler case but said generally staff are trained to spot potential warning signs and share observations with clinicians.

“We have an interdisciplinary team process that, as we review service plans and hear from nurses and CNAs at the bedside, we incorporate the clinical review and reach out to the appropriate clinicians, whether that’s a psychologist or a therapist,” Solava said.

Chassee said she believes the part of Tom Dowler’s note that said no one knew about what he was doing, including his wife.

“She’s not a very good liar,” Chassee said. “I don’t think you can fake something like that.”

She said she understands why people get angry in cases like this, how they view actions like Tom Dowler’s to be selfish.

“I’m saddened by it, but I’m not angry,” she said. “I’m not upset with him because I think, in his mind, he was thinking he was doing what was best.”

She wonders if a longer waiting period to buy a gun than the current three days might have made a difference. Dowler bought the revolver three days before the shooting and left the receipt on the kitchen table, Chassee said.

“Even if it had been a week or two, maybe things might have turned around and he might not have felt desperate,” she said.

Chassee said the couple should be remembered for who they were, how they lived and how much they loved each other, not for how they died.

“One incident,” she said, “doesn’t define a life.”

Need help?

Contact the National Suicide Prevention Lifeline at 988, visit suicidepreventionlifeline.org, or call the Crisis Center of Tampa Bay by dialing 2-1-1.

The state of Florida offers a range of assistance for caregivers. For more information, go to elderaffairs.org/resource-directory/caregiver-assistance-programs/