The woman's son, Ralph Sowers III, told a 9-1-1 dispatcher he survived because his stepfather, Paul Gilkey, said he was sparing him because he had kids.
After the shootings Monday, Paul Gilkey, 63, stepped out onto his front porch, sat 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, 38, of Columbus.
North 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.
That led to an argument that escalated over time and culminated in the shootings, the sheriff said.
As the argument heated up, Paul Gilkey left the living room where his wife's bed was, went to a bedroom and grabbed a gun, returned to the living room and started shooting.
The sheriff said Gilkey shot Mohler first, then ordered Sowers to leave. Gilkey then shot his son and again ordered Sowers to leave, before shooting Cherry, North said.
Hocking County Coroner David Cummin 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 of a gunshot wound to the chest and a close-range gunshot wound to the head, the autopsies showed.
Paul Gilkey shot himself in the chest.
A sobbing Sowers described in a nearly hour-long 9-1-1 call how Paul Gilkey shot his son, who was Sowers' brother.
"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 9-1-1 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.
The house sits at the end of a gravel lane amid rolling, wooded hills dotted with farmland near Logan, about 50 miles southeast of Columbus.
Paul Gilkey, who went by David, served a decade in prison beginning in 1974 for killing a man in Athens County in May of that year, according to court records.