Wow, I feel lonely. We still do gift exchanges, presents for spouses, etc. Not to support crass consumerism, but because we enjoy it.
As far as grandparents, I hear ya. They can be hard to buy for. My elderly mother-in-law liked to work, even just around the house, therefore rarely did anything involving hobbies or relaxation. Hard to buy for that kind of person. She wasn't interested in other people
doing things for her...in fact, she found that kind of insulting and frustrating.
My sister-in-law did come up with a nice idea. Since my mother-in-law lived with us, she found out which TV shows used to amuse her years ago, and bought DVDs of them. Personally I find
The Lucy Show idiotic, but my mother-in-law sure enjoyed them. At least we could get her to sit down for a half-hour at a time.

Books and music are always good too,
if you can find out what interests them.