Independent outdoor mobility (IOM) is vital for older adults’ quality of life but poses challenges for those with dementia. Caregivers, especially adult children in Chinese contexts, often face ambivalence when balancing safety and autonomy in IOM decisions. This study proposes a biopsychosocial model integrating Behavior Reasoning Theory and prospect theory, using a Delphi study and a randomized vignette experiment with eye-tracking. It aims to explore caregivers’ decision mechanisms and inform person-centered interventions to enhance autonomy and safety in IOM for people with dementia.