Poor little baby!!!! I am so sorry that you and he are going through this!
My first inclination is that this is being caused by his age. HIs poor little body may be breaking down. It might help a little if you lower the water level so he doesn't have to exert so much energy to get to the top.
If he can't rise to the top easily, that is indicative of a swim bladder issue (not constipation or fluid build up). It is hard for him to regulate his swim bladder, adding or expelling air as he needs to. If there is an internal infection, then usually you will begin to see a bulge and/or fluid retention.
If he is struggling to breathe, you could add a little aquarium salt to the tank to help with that. If he is not struggling to breathe, then you won't necessarily need to add any aquarium salt.
I personally would not try to treat him with any kind of med or antibiotic unless you are pretty sure that it is an infection. Antibiotics will kill off the
beneficial bacteria in your tank and can be stressful for the fish. It's not good to use antibiotics unless you are pretty sure about what is happening.
If he wants to eat, then feed him. Keep him warm, and maybe do those very small
water changes to keep his water pristine.
I hope he bounces back from this, but when they get to the point that they are not really moving, and when they start to refuse to eat, it is usually a sign that they are at the end of life.