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They refuse to go to a nursing home and one has dementia really bad. There is nobody in the family that can care for them in their own home because everybody has to work. Also nobody has the financial resourses to pay for sitters.

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You call your local area agency on aging and ask for help.

Does anyone have POA? Would they accept a small bit of help, like a laundress or cleaning help, introduced as a friend? Sometimes you have to be creative in getting a foot in the door.

You may, sadly, have to wait for a fall or other mishap to occur, at which point you enlist the aid of the discharge department to find them a suitable placement. Just make sure that discharge understands what their actual living situation is like, and that there is not a nearby child able to provide assistance on an ongoing basis.
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Have you sat down with them to find out why they are running help off? Receiving help is very difficult for seniors, it is seen as a loss of control. I know a lot of times we as caregivers are task oriented, we see help is needed and we want to give it, a lot of times we do not pause when we see resistance to find out WHY. I would start there, find out why. Also, them to have involvement as to who can help and how they can help, make sure they are as involved as possible in the decision making process of their care, that might help the situation out a lot.
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ask what they hate about having a caregiver if just don't want one tell them the state will be called and they will go to a nursing home if they keep this up. we need you safe first happy second. good luck
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buddylab, are your parents refusing help that is sent to the door because the help is of a different ethic group, etc? My parents are of that generation that they don't trust anyone unless that person is of their own ethic group, and own religion. My parents have made it quite clear they don't like their primary doctor because that doctor is a woman.... [sigh].
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One lesson I learned was to include Dad in the selection process. When we selected people he sent them packing. This included a cousin who does elder care for a living. She cooked him the food he grew up with and loved. It didn't matter. We learned to screen people and then give him the choice. That seemed to work a whole lot better.

Is it possible that someone else is giving them advice? It turned out that there was a woman who we had fired as a care giver who was staying in his house at times. He did not want a live-in person because this woman was telling him she would take care of him. She wanted a free room to stay to avoid a long commute.
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As Babalou says, you may have to wait a while before they will accept help. Now is the time to get the paperwork in order "just in case" so that when the fall, car crash, massive food poisoning, robbery, burglary, car theft, assault, or influenza strikes and disables they, the paperwork is done. By this I mean the DPOA. Ask their family physician to perform mental exams on them for a baseline for future reference. I've been there, it was very frustrating.
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Sophe 509 is right. A mental check up could put you in the position to obtain guardianship. That may be the only solution.
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If you get poa are you accepting their debt as well ?
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You are not accepting their debt. You want an eldercare attorney to explain this to you.
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It is important to know your parents financials, as their POA, to help plan for their future. Now, I understand that most adult children feel uncomfortable about diving in to their parents personal stuff. I had to do this with my mom after she suffered a massive stroke, which left her 87% wheelchair dependent. Many elderly couples are able to live in their home with help from Medicaid. With a little bit of planning from an advocate, your parents could stay home, safely, with caregivers in place paid for by Medicaid. While waiting for Medicaid to become active, your parents would have to private pay for about 3 months for caregivers. I'm telling you this because I don't want you to think that the nursing home is the only answer; there are other options.
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