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My aged parents, 88 and 86 live independently in their own home. They manage their lives fairly well, despite some bad decision making that i chalk up to their general disposition not necessarily dementia or mental illness which i know my mother suffers from.

They had a bed bug infestation last year which they begrudgingly had treated with heat. It worked.

One year later they are back. My adult mentally disabled brother lives with them as well. He is a roamer and they are loathe to confront him. I suspect he is the source of the reinfestionation.

I have visually confirmed the bugs.

We have had to cut off all physical ties to them until they treat the issue. No car rides or visits unless they change their clothes into items i have heated in my dryer previously included shoes etc. i have three young children and do not want the infestation here as well.

They just don’t want to spend the money are are OKAY with the arrangement.

Im looking ro support here as well as wondering at what point do we decide they cant live on their own. At what point are their decision making skills no long working?

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I don't think their stubborn refusal to face up to this infestation problem is going to swing it for you.

Also, even if they do see sense and get rid of the loathsome little creatures, unless they also address your brother's travelling habits it's only going to happen again. Bedbug infestation is a quietly growing plague worldwide.

Oooh it makes me shudder for you - I can't bear them, horrible!

I think you're absolutely right to impose the sort-of quarantine measures, so to speak. But as for next steps: okay, if they won't listen to reason from you, is there anyone else you can think of who might get them to think a bit harder about their plans going forward, both this immediate problem and more generally about how they plan to manage as they get older and what's to become of your brother?

They can maybe stick their heads in the sand for now, but not forever. Any allies spring to mind?
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ThAnkyou mouse. I know this is an uphill battle. They are in denial. The only thing I am waiting for the tenant to complain. That's the only cudgel I can imagine.
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Dealt with bedbugs, a stubborn/dementia-minded?/low income father last year. It was a nightmare! Very costly to husband and I, monetarily and mentally exhausting! Dad even had a nest in his hat etc etc them in our home but only in 1 room (caught them early on) we destroyed everything with fire!! They're beasts!! They only come out to eat when hungry...I hate them!! Dad had PTSD from them!
Looking back I would not deal with these on our own and do not recommend anyone to. In our case I would have called APS!!
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Liz, as to at which point are your parent's decision making skills no longer working - I think, sadly, they're already arrived and passed that point.

Regardless of whether dementia is present or not, I think that the aging process often includes seguing from being proactive, to just responding, to just accepting. Sometimes it's too much for older people to conceive of and implement remediation measures. It's just so overwhelming.

I think you do have to step in again, but my suggestion isn't made lightly. It's that you might need to involve the county health department, anonymously, of course. You have to weigh the issue of whether or not your parents would suspect you though, and how you would feel about that.

But they're not living in safe conditions; they've living in unhealthy conditions. And your brother needs to be in a place where he has oversight management and can't wander to the point of bringing in insect infestations.

I know this can't be easy, for a lot of reasons. But for his own health, and the health of your parents, if he's the carrier, that needs to be addressed. And having said that, I really don't know how that would be done.

What are these "wanderings"? What do they consist of? I assume he's wandering to filthy places. Is there any way to contain his meanderings? Has a placement with others of similar status been considered?

I wish you success and peace as you address this challenging issue. It's got to be demanding and depressing for you.
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This tough. My folks should have moved to assisted living 5 years ago but are still hanging by a thread at home. Neither of them have executive  reasoning skills any more but are not legally incompetent so I can't force them to do anything. So I'm just waiting for the crisis that forces the issue.

The bed bug problem may be your crisis. If your folks don't cooperate to resolve it then you may have to get local authorities involved. But I see this getting worse before you or authorities can force them into care.

What about in home help, cleaning service etc?  

This is all made extra tough by the disabled brother living there. You've got three people who are going to need care.

I wish I had more encouraging words for you but this is so common.  We do what we can, as much as our stubborn failing elders will allow and then usually have to sit back and wait for the big mess that ends the party.
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Our health department wouldn't do anything to help.
I wish you luck, I'm sorry you and your parents are dealing with this.
My dad couldn't comprehend the seriousness of it.
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Slept on it... (no pun intended)

How would it go down if you rang your local pest control wizards, made an appointment for them to come and assess the problem, then rang your parents and said "John Zapp will be with you at eleven on Monday morning to provide an estimate"? Sometimes a fait accompli works wonders..? :)
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