"Are there compelling reasons to have children going to college (age 18 and older) put in place a DPA or medical directive?"
Yes. If a child (who must be the age of majority or adult to sign (execute) legal documents like a power of attorney, living will or health proxy) is off to college they should sign these documents. If the child is away at college, especially at a distance, if an issue arises that needs to be taken care of at home (e.g., a CD the child invested in matured, a tax bill from the IRS arrives) you need a power of attorney to help take care of these matters. If the child should be sick or injured, once an adult, you need a power, medical directive, etc. to be able to make medical and financial decisions for the child. Signing these documents should really be a right of passage of everyone celebrating their 18th birthday (or whatever the age of majority is in your state).