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My Dad is 98, still of sound mind and able to get around. Usually no problems but this rash is concerning me. He hates the doctor and takes very little medication.

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Does he sit in a chair all day? It is one of those things that happen when the back is against something all day. It is the first thing I would think of. But really, he does need to go to a doctor. He may be able to give him a cream for the rash.
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If it's heat rash, he needs to avoid sweating a lot. If his clothes get wet, it needs to be changed. Therefore, it's best to have the air conditioner on and not too much clothing making him sweat. I found with my dad, that a sweater or thin jacket kept him warm - but he would sweat a lot, and rashes came out all over his back, under his arms which had skin-to-skin contact. Yet, without the jacket, he was freezing. I see the Japanese tourist ladies walking around the hot sun wearing this long thin gloves (so their very fair skin doesn't turn brown.) I went to ebay and google male long sleeve gloves. I finally found some which had an opening for his thumb. This has worked perfectly. When he gets too hot, he just pushes the sleeve down to his wrists. When he's cold, he pulls it up as high as possible.

I would use either Calmoseptine or calamine lotion on his rashes. If these rashes continue to spread and become angry red looking, I conclude that he has fungus. I would request the home care nurse for a topical prescription, and this usually gets rid of the rashes.

So, first try the home remedies like keeping him dry, topical ointments. If that fails to work, then it's time for a prescription.
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If you haven't changed your laundry detergent (to which he might be having an allergic reaction), maybe try some medicated body powder (Bonds is the only one I can think of). Change dad's shirts frequently so he's not sitting in a wet shirt. Do you have air conditioning? What's his day like, i.e. is he sitting around a lot? Sweating a lot? Tell us more...it's only on his back? If it's from sitting, you'd think it would be on his legs too...I'd think a food allergic reaction would be body-wide and not just on his back. Tell us a bit more.
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It could also be shingles. Is it painful?

http://www.webmd.com/skin-problems-and-treatments/shingles/ss/slideshow-shingles-pictures

Some photos show close-ups, a mass rash, and other slides address treatment.

My father was treated with a lidocaine patch for pain and I believe (but don't recall for sure) a med to help healing.

Has your father had chicken pox? The virus can remain dorman for years. My father's outbreak occurred after an intensely stressful several months.

Rehab staff had to mask, gown and glove when they worked with him. I masked and gloved but never had an outbreak. There is a certain period of time during the outbreak in which contagion exists.

If he's had chicken pox, the rash is painful and isn't healing, you'll have to insist that he see a doctor, whether he wants to or not. Shingles needs medical treatment.

Good luck with this.
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