My cat Louie is almost 10 years old and lately has been having difficulty going to the litterbox.
He's had issues in the past, but usually will revert back and not have major problems. This year however, its been getting worse. I've taken him to the vet before to rule out any health issues, when this first started happening and he was fine. I've had him since he was a baby kitten. He can get very needy and emotional. Right before he needs to "relieve" himself, he starts to get skiddish, hides under the couch and does it under there. I'm starting to lose patience and don't know what to do. Any ideas?

It's possible that he has been (or is) constipated, or I would have guessed a possible mild urinary tract infection that made going to the bathroom painful. When this happens, cats sometimes associate going in the box with that pain. That might also explain the fearfulness before doing his business.

You could try putting in a new kind of litter box, moving the box and/or changing your brand of litter... it might help. Just an idea.