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He refuses his psychiatric meds only. We were told to crush them hide them in food by the dr. However he still tries to avoid them. I work with another home care worker 24/7. The 90 year old is a father of a friend. When he refuses meds he’s agitated, verbally insulting and aggressive with his behavior. Makes sexual comments and points and growls when he’s upset. I think we’ve tried every way to fix or make things easier. But it doesn’t work. He refuses meds due to the stigma of them. When taking his meds regularly he’s pleasant. Any advice would be appreciated.

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If he is that agitated by the meds I would let his doctor know and stop offering them. He has a right not to take them. If he is pleasant otherwise I would move on.
I have a family member who even in a state hospital for the mentally ill would not take her meds for her bipolar disorder. She finally agreed to take them so she could pass a test required before she could be released. Once she got out, she quit taking them and has since been hospitalized several times. Many of her issues can be successfully managed as long as she takes the meds. She will not. It’s sad but it’s her “right”.
it could be that this elder will not object to them as vehemently in the future. Dementia (if that is the issue) is progressive and he might forget he doesn’t want to take them.
I would also suggest that you check out Teepa Snow videos on YouTube. She gives excellent insight on how to better deal with these issues.
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If you are successfully camouflaging his meds in his food, how is he spotting them?

Is he not eating to avoid taking meds? Ask the doctor what foods or liquid is best to disguise the taste or appearance of his meds.

It’s so sad that there is a stigma regarding psych meds.

Some people do benefit greatly from them. For some it is temporary, others it is permanent. No one should be ashamed of taking meds.

Monitoring is extremely important as all meds effect everyone differently.

Has his doctor, nurse and caregivers explained that not everyone will get all of the side effects listed?

Has it been explained that it can take several weeks before a med is working at the optimum level?

Has he been told that it’s important to speak about symptoms, in case dosages need to be adjusted, or perhaps a different med altogether or another med added in conjunction with the original med prescribed.

I ask this because some people read the list of side effects and become frightened.

Best of luck to you with working through this hurdle.
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