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He has always been in total control so his personality isn’t changing and I’m the quiet one! We’ve been married 41 years so it’s pretty heartbreaking. Should I let him decide for now, or keep asking him to do something he will not do and it upsets him etc.

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Yes, I don't see why you need to force a person to take Meds when they are on Hospice. Maybe he can tolerate the pain and the pills make him drowsy and he wants to be awake. I think that its good that he is in control. IMO, no med should be forced on a Hospice patient if they are competent to make decisions. Now if you see his anxiety is rising, then sneak his med in. Not good to have anxiety. You cam measure pain by taking his blood pressure. It rises when ur in pain. But he should be load to be in control.
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He's in hospice, he is dying, and the meds aren't going to change that. Let him know that there are pain meds available if he needs them and you can offer them if it appears that he needs them. But it really is his choice, isn't it? Allow him the respect of that choice without argument or making him justify his decision.
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Discuss this with Hospice. They are the ones prescribing. They can let you know which are most important to hubby's comfort. And how you might sneak them into his favorite food if they are truly needed. They can best advise you as they know your husband's case and the medications involved.
This is what Hospice is there for. Reach out to them. Wishing you the very best.
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He's in hospice care. We all know the outcome of that whether he takes meds or not.

He's trying to have some control over his life, so let him. If theypre pain meds, maybe he'll finally ask for them when the pain is bad enough, OR he wants to feel the pain because it tells him he's alive.

Leave the man alone.
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I'm assuming they are pain meds since he is in hospice. You can ask the doctor if they come in patch or other form.
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