This manuscript discusses depression among elderly spouse caregivers & the lethal consequences, murder-suicide, that can result when the depression goes unrecognized & untreated. Husbands are usually the perpetrators in these cases because they lack the social networks that many older women have. Health professionals should screen caregivers for symptoms of depression & be able to make referrals. Other caregivers & family members need to convey clear messages of emotional & practical support.