How can you tell if death is about to occur for a critically ill patient? According to About.com there are common signs that may indicate that death is actively approaching. These include:

• Major changes in respiratory health, buildup of fluid in the lungs, congestion, longer periods of apnea, and abnormal breathing patterns such as cycles of slow then fast breathing. 
  
• Subject states that he or she is going to die soon.
  
• Difficulties swallowing liquids or the resistance of all food and drink. 
  
• Marked changes in personality, acting wildly, severe agitation or hallucinations. 
  
• Increased difficulty waking subject from sleeping, the inability to arouse them at all, or a coma-like state. 
  
• Subject is unresponsive or cannot speak. 
  
• Subject does not move for long periods of time.
  
• The extremities -- hands, feet, arms and legs -- feel very cold to touch. Subject may say that they are numb or cannot feel at all. 
  
• Mottling of the arms, legs, hands and feet -- giving a blue or purple splotchy appearance to the skin. 
  
• Decrease in urination with urine darkening in color or changing colors. 
  
• Urinary or bowel incontinence. 
  
• A continued drop in blood pressure to 20 to 30 points below normal range or a systolic pressure below 70 with a diastolic below 50 points.
  
• Loss of hearing, feeling, smell, taste or sight at the final stage. 
  

It is important to provide a warm and relaxing atmosphere and be supportive during the time of transition. It is believed that the dying can sense people in the room and hear them speaking. Find comforting words to help alleviate fear or anxiety. Avoid crying or grieving while in the room with the dying person. Take turns with friends and family staying with the dying person so they do not have to be alone. Be assured that whatever happens is a normal part of the process and see yourself as being a blessing as you offer your time and love.