This book almost received 4 stars with the caveat that it's really a 3.5, but... one of my oddball criteria for four stars is whether I would tell one of my daughters that I think they'd enjoy it. (For five stars, I have to insist my daughters would read a book.) So this one, no - I can hear my oldest daughter's voice now (if she were to read this book) saying, "What's the point, mom?"
I think "Flowers for Elvis" is supposed to fall into the category of "magical realism," told in the voice of the spirit of a stillborn twin, as she plays guardian guide to the living twin. Throughout the book, the living twin experiences life in a crazy, conflicted - rather modern Southern gothic - setting. In the end, there were some interesting folks here, but I didn't care deeply about any of them, root strongly for any outcome, and derived my greatest pleasure from predicting the conclusion of the book.
Incidentally, the Kindle editing was poor for this book. For some strange reason, every time a word began with the letter "j" it was separated from the rest of the word. A couple other visible typos, too, but the "j" thing caused a reading disruption.