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Do a search on the site and you will find this discussed several times. There are two major view points. I was taught that private duty is home care that is paid for by the client/client's family out of pocket, no third party involved. Others will tell you that private duty is providing care to one patient in the home for a shift, whether or not your employer is an agency or the client. That is the general description of home health extended care, also called shift work, or continuous care and really applies to all shift home care except the short duration visits that are referred to as intermittent visits. The only distinguishing characteristic is that in private duty the patient/client/client's family pays for the home care provided to the patient. That is how I was taught in school as reinforced by my first employers. Like I said, others go with the other view. Either way, the patient receives nursing care in the home. Usually private duty is paid by the patient (thus private). Extended care, shift care, continuous care cases are handled by an agency and the nurse is an employee of the agency. When you work without an agency, you have to be proactive about your working conditions and always make certain you have a contract with the client.