Well, John and greaseburgers are involved in this.
Panel 1: We start of with JSTF grilling up the evening meal on the barbeque. He asks Elly how Jim is. Instead of telling him that could have have jolly well taken a few minutes to see for himself instead of playing with toys, she reports that he's looking better and that Iris had a nice break from her self-appointed task as Jim's caregiver.
Panel 2: She then fills the panel with the statement that looking after him is a lot of work because of the fear that he'll fall or choke on something.
Panel 3: She then states that Jim is so lucky to have her around to care for him when he's failing, frightened or needs help. John could have mentioned that a licensed and trained professional could do all those things more effectively but instead simply agrees with her premise.
Panel 4: They then both thought-bubble their real concern; which one of them will have to do that when this happens to them. I thought that securing a free nursemaid was the whole point of the Settlepocalypse and Housening. They may approve of Iris suffering in silence and not asking anythong of them but the John and Elly I know would expect their kids to wait on them hand and foot.
Summary: In hindsight, it was obvious that this would be about them in the end.