When I was dating my husband many years ago and about to meet his mom for the first time he told me " one thing you should know about my mom- she's 99% b.s. I was shocked, but found it to be true. My MIL of 35 years has an undiagnosed personality disorder. She constantly lies, makes up stories and according to her is personal friends with stars and related to just about anyone of royalty. We've gotten used to it over the years and have learned to ignore it.
More recently she's developed severe paranoia, agoraphobia, and anxiety. She believes people are breaking in stealing her things and accuses my father in law of violence ,having sundowners, and affairs, hiding her phone so she can't call the police on him, and stealing her jewlry. She has blocked all the entrances to the rooms in her house with chairs and boxes, and bunggy corded all the cabinets and drawers shut . She follows him around yelling at him that he is stealing her things and tried to hit him and he stopped her by grabbing her wrist. Being elderly this caused a bruise. She had him arrested and he was put pysch watch because she told them he's violent due to Alzheimer's! He refuses to stand up for himself and allow us to help. He says he can handle it. She won't go to the doctors ( anxiety, agoraphobia) won't let a nurse in the house.... Is there anything we can do or should we just wait until there is a major crisis. My father in law has his own health problems.we are so frustrated. My poor husband is soo stressed.
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It sounds like the two of them have a very enmeshed situation which is not going to do anything but deteriorate if left alone. Sometimes that really is your only choice - let Humpty Dumpty fall off the wall.
If you can get FIL alone, tell him that you're worried about his wife, but you know she won't consent to care while he's there. Saying it this way doesn't infer that he can't handle it - something he might not be willing to admit to himself.
Can he temporarily come live with you or do a stint in senior respite care, so you can fully attend to the MIL? He may not be aware of how draining she is on him until he gets a break from her and can really truly relax. Having grown up with a Cluster B personality disorder mother, I can attest to the fact that you need more than 2-3 days of relaxation time to really start to get your feet back under you.
Tell the police department there are two vulnerable seniors in that house and you'd appreciate a welfare check because it's unsafe. Entrances are blocked and an EMT couldn't get through.
The ultimate answer is to rescue FIL and then have MIL placed in care. That is the only way she can get access to the medication and 24/7 care she needs. That was the only way my mom was going to see a geriatric psychiatrist - when he came to her. Wild horses wouldn't have gotten into an office voluntarily.
Otherwise, as you said, you may have to wait for there to be an emergency to make some changes. But if your FIL is in his right mind you can't force him to do anything.