Panel 1: John and Elly are driving somewhere with a casserole in tow. This must mean they're going to see Jim.
Panel 2: This assumption is confirmed by their entering his building.
Panel 3: Iris greets them at the door. Given how rarely people show up, her enthusiam is, sadly, understandable.
Panel 4: She explains to Jim that Elly and John brought over a roast beef dinner. This is because she is unsure if he remembers who these two are and what that smell is.
Panel 5: She then gushes about how happy he is to see them. At his age, he'd be happy to see Hannibal Lecter so that isn't much of a compliment.
Panel 6: She volunteers to cut his steak for him...
Panel 7: And use the special fork. His facial expression indicates that he's gotten used to Iris treating him like a toddler.
Panel 8: Elly asks her if Jim knows this is his birthday party. Iris says she isn't sure. This, of course, means that she wouldn't risk antagonizing the doctor by having his condition re-evaluated. This will backfire on her in a few days when they want to wash their hands of guilt over not seeing him when he was alive. Suddenly, the woman who did so much will not have done enough.
Panel 9: She then goes on to say that even if he doesn't, it doesn't matter 'cause he's still with them.
Panel 10: She then delivers a fridgeworthy remark about every day with him being a celebration in its own right. Jim, on the other hand, wants his cake NOW! It's his 87th birthday, after all.
Hypothesis: If Jim does not die at the reception, his death will precipitate the Settlenuptuals.